title: Cost-Effectiveness of a Short Message Service Intervention to Prevent Type 2 Diabetes from Impaired Glucose Tolerance.
abstract: Aims. To investigate the costs and cost-effectiveness of a short message service (SMS) intervention to prevent the onset of type 2 diabetes mellitus (T2DM) in subjects with impaired glucose tolerance (IGT). Methods. A Markov model was developed to simulate the cost and effectiveness outcomes of the SMS intervention and usual clinical practice from the health provider's perspective. The direct programme costs and the two-year SMS intervention costs were evaluated in subjects with IGT. All costs were expressed in 2011 US dollars. The incremental cost-effectiveness ratio was calculated as cost per T2DM onset prevented, cost per life year gained, and cost per quality adjusted life year (QALY) gained. Results. Within the two-year trial period, the net intervention cost of the SMS group was $42.03 per subject. The SMS intervention managed to reduce 5.05% onset of diabetes, resulting in saving $118.39 per subject over two years. In the lifetime model, the SMS intervention dominated the control by gaining an additional 0.071 QALY and saving $1020.35 per person. The SMS intervention remained dominant in all sensitivity analyses. Conclusions. The SMS intervention for IGT subjects had the superiority of lower monetary cost and a considerable improvement in preventing or delaying the T2DM onset. This trial is registered with ClinicalTrials.gov NCT01556880.
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Carlos K H
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Fang-Fang
authors.initials: FF
authors.lastname: Jiao
authors.affiliation: Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital, Causeway Bay, Hong Kong.
authors.forename: Shing-Chung
authors.initials: SC
authors.lastname: Siu
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Colman S C
authors.initials: CS
authors.lastname: Fung
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Daniel Y T
authors.initials: DY
authors.lastname: Fong
authors.affiliation: Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital, Causeway Bay, Hong Kong.
authors.forename: Ka-Wai
authors.initials: KW
authors.lastname: Wong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Esther Y T
authors.initials: EY
authors.lastname: Yu
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Yvonne Y C
authors.initials: YY
authors.lastname: Lo
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
authors.forename: Cindy L K
authors.initials: CL
authors.lastname: Lam
mesh_terms: D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control*; D018450:Disease Progression; D018149:Glucose Intolerance / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D017048:Health Care Costs; D006723:Hong Kong; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D011236:Prediabetic State / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D011322:Primary Prevention / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D017010:Reminder Systems / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome