title: Five-year cost-effectiveness of the Patient Empowerment Programme (PEP) for type 2 diabetes mellitus in primary care.
abstract: This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus (DM) in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. Outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a 5-year follow-up period and the number needed to treat (NNT) to avoid 1 event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT. The PEP cost per subject from the societal perspective was US$247. There was a significantly lower cumulative incidence of all-cause mortality (2.9% vs 4.6%, P < .001), any DM complication (9.5% vs 10.8%, P = .001) and CVD events (6.8% vs 7.6%, P = .018), in the PEP group. The costs per death from any cause, DM complication or case of CVD avoided were US$14 465, US$19 617 and US$30 796, respectively. The extra amount allocated to managing PEP was small and it appears cost-effective in the short-term as an addition to RAMP.
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Jinxiao
authors.initials: J
authors.lastname: Lian
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: McGhee
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Ching
authors.initials: C
authors.lastname: So
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: June
authors.initials: J
authors.lastname: Chau
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Carlos K H
authors.identifier: 0000-0002-6895-6071
authors.initials: CKH
authors.lastname: Wong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: William C W
authors.initials: WCW
authors.lastname: Wong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Cindy L K
authors.initials: CLK
authors.lastname: Lam
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics / Q000401:mortality / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D058065:Diabetic Cardiomyopathies / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D005500:Follow-Up Studies; D017048:Health Care Costs; D000070497:Healthy Lifestyle; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D018803:Models, Economic; D009026:Mortality; D010353:Patient Education as Topic / Q000191:economics; D010358:Patient Participation / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*; D020377:Self Efficacy; D000073278:Self-Management / Q000191:economics*
keywords: cost-effectiveness; primary care; type 2 diabetes