title: Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK.
abstract: To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework.
  
  
  
  A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person.
  
  
  
  All interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs.
  
  
  
  The model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: P R
authors.initials: PR
authors.lastname: Breeze
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: H
authors.initials: H
authors.lastname: Squires
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: A
authors.initials: A
authors.lastname: Brennan
authors.affiliation: University of Exeter Medical School, University of Exeter, Exeter.
authors.forename: C
authors.initials: C
authors.lastname: Greaves
authors.affiliation: Medical School, Lancaster University, Lancaster.|Institute of Infection and Global Health, University of Liverpool, Liverpool.
authors.forename: P
authors.initials: P
authors.lastname: Diggle
authors.affiliation: Epidemiology and Public Health, University College London, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Brunner
authors.affiliation: Epidemiology and Public Health, University College London, London, UK.|First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Tabak
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: L
authors.initials: L
authors.lastname: Preston
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield.
authors.forename: J
authors.initials: J
authors.lastname: Chilcott
mesh_terms: D002253:Carbonated Beverages / Q000009:adverse effects / Q000191:economics; D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control*; D000072001:Diet, Healthy / Q000191:economics; D004739:England; D006266:Health Education / Q000191:economics; D006291:Health Policy; D006293:Health Promotion / Q000191:economics*; D006306:Health Surveys; D000070497:Healthy Lifestyle; D006801:Humans; D008403:Mass Screening / Q000191:economics; D018803:Models, Economic; D011788:Quality of Life; D012111:Residence Characteristics; D013660:Taxes; D017132:Workplace