Pornpan Khwakhong, Wiroj Jiamjarasrangsi, Youwanuch Sattayasomboon and Arunya Tuicompee
This study aimed to evaluate the cost-effecti veness of a healthcare professional-led type 2 diabetes mellitus self-management support program (DM-SMS ) for a period of 6 months in public health centers in Bangkok, Thailand. Cost and cost-util ity analyses were performed in the context o f clinical trials that aimed to examine the ef fectiveness of the healthcare professional-led DM-SMS program compared with usual type 2 diabetes c are. One hundred and seventy-six type 2 diabe tic patients within a set criteria (i.e., aged > 20 years old, glycated hemoglobin or HbA1c > 7%, and seeking healthcare at a Bangkok public health center) participated in this study. Eighty-six patients received the DM-SMS program and 88 patients received the usual care. Data regarding costs focusing on the intervention and treatment for the physician-appointed visit were collected alongside the clinical trial. Outcomes such as qu ality of life were estimated. These economic analys es were done from both the healthcare provider’s and s ocietal perspectives. The findings revealed that the cost of the program was 1,960 baht per perso n. The total cost with respect to diabetes pa tients from the two different perspectives were 8,550 (health provider’s perspective) and 12,098 (soci etal perspective) baht per person . The quality of life of patients in the intervention group as compared with those in the usual care group increased (0.02). The cost-utility results were 34,400 and 96,350 baht p er QALY gain from the healthcare provider’s and societ al perspectives, respectively. According to the sensitivity analysis, the cost affected the incremental cost utility ratio (ICUR) to a high deg ree. In summary, the healthcare professional-led DM-SMS program requires only a small investment at startup and moderate implementation costs asso ciated with patients. These investment costs with a small return in the improvement of quality of life would be perhaps mitigated by investment in a long term and sustainable DM-SMS program.
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