A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes

Gordon, L. G., Bird, D., Oldenburg, B., Friedman, R. H., Russell, A. W. and Scuffham, P. A. (2014) A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes. Diabetes Research and Clinical Practice, 104 1: 103-111. doi:10.1016/j.diabres.2013.12.032

Author Gordon, L. G.
Bird, D.
Oldenburg, B.
Friedman, R. H.
Russell, A. W.
Scuffham, P. A.
Title A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes
Journal name Diabetes Research and Clinical Practice   Check publisher's open access policy
ISSN 0168-8227
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.diabres.2013.12.032
Open Access Status DOI
Volume 104
Issue 1
Start page 103
End page 111
Total pages 9
Place of publication Shannon, Co. Clare Ireland
Publisher Elsevier Ireland Ltd
Language eng
Subject 2712 Endocrinology, Diabetes and Metabolism
2724 Internal Medicine
1310 Endocrinology
Abstract Aim: To assess the cost-effectiveness of an automated telephone-linked care intervention, Australian TLC Diabetes, delivered over 6 months to patients with established Type 2 diabetes mellitus and high glycated haemoglobin level, compared to usual care. Methods: A Markov model was designed to synthesize data from a randomized controlled trial of TLC Diabetes (n=120) and other published evidence. The 5-year model consisted of three health states related to glycaemic control: 'sub-optimal' HbA1c ≥58mmol/mol (7.5%); 'average' ≥48-57mmol/mol (6.5-7.4%) and 'optimal' <48mmol/mol (6.5%) and a fourth state 'all-cause death'. Key outcomes of the model include discounted health system costs and quality-adjusted life years (QALYS) using SF-6D utility weights. Univariate and probabilistic sensitivity analyses were undertaken. Results: Annual medication costs for the intervention group were lower than usual care [Intervention: £1076 (95%CI: £947, £1206) versus usual care £1271 (95%CI: £1115, £1428) p= 0.052]. The estimated mean cost for intervention group participants over five years, including the intervention cost, was £17,152 versus £17,835 for the usual care group. The corresponding mean QALYs were 3.381 (SD 0.40) for the intervention group and 3.377 (SD 0.41) for the usual care group. Results were sensitive to the model duration, utility values and medication costs. Conclusion: The Australian TLC Diabetes intervention was a low-cost investment for individuals with established diabetes and may result in medication cost-savings to the health system. Although QALYs were similar between groups, other benefits arising from the intervention should also be considered when determining the overall value of this strategy.
Keyword Cost effectiveness analysis
Tele health
Type 2 diabetes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
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