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Article: Cost-effectiveness of a primary care multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) over lifetime

TitleCost-effectiveness of a primary care multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) over lifetime
Authors
KeywordsPrimary care
Cost-effectiveness
Diabetes mellitus
Multidisciplinary
Risk assessment and management
Issue Date2019
Citation
Endocrine, 2019, v. 63 n. 2, p. 259-269 How to Cite?
AbstractPurpose: The multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) was found to be cost-saving in comparison with usual primary care over 5 years’ follow-up. This study aimed to estimate the cost-effectiveness of RAMP-DM over lifetime. Methods: We built a Discrete Event Simulation model to evaluate the cost-effectiveness of RAMP-DM over lifespan from public health service provider’s perspective. Transition probabilities among disease states were extrapolated from a cohort of 17,140 propensity score matched participants in RAMP-DM and those under usual primary care over 5-year’s follow-up. The mortality of patients with specific DM-related complications was estimated from a cohort of 206,238 patients with diabetes. Health preference and direct medical costs of DM patients referred to our previous studies among Chinese DM patients. Results: RAMP-DM individuals gained 0.745 QALYs and cost US$1404 less than those under usual care. The probabilistic sensitivity analysis found that RAMP-DM had 86.0% chance of being cost-saving compared to usual care under the assumptions and estimates used in the model. The probability of RAMP-DM being cost-effective compared to usual care would be over 99%, when the willingness to pay threshold is HK$20,000 (US$ 2564) or higher. Conclusion: RAMP-DM added to usual primary care was cost-saving in managing people with diabetes over lifetime. These findings support the integration of RAMP-DM as part of routine primary care for all patients with diabetes.
Persistent Identifierhttp://hdl.handle.net/10722/267600
ISSN
2017 Impact Factor: 3.179

 

DC FieldValueLanguage
dc.contributor.authorJ, F-
dc.contributor.authorWan, YF-
dc.contributor.authorFung, CSC-
dc.contributor.authorChan, KC-
dc.contributor.authorMcGhee, S-
dc.contributor.authorKwok, RLP-
dc.contributor.authorLam, CLK-
dc.date.accessioned2019-02-22T04:08:28Z-
dc.date.available2019-02-22T04:08:28Z-
dc.date.issued2019-
dc.identifier.citationEndocrine, 2019, v. 63 n. 2, p. 259-269-
dc.identifier.issn1355-008X-
dc.identifier.urihttp://hdl.handle.net/10722/267600-
dc.description.abstractPurpose: The multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) was found to be cost-saving in comparison with usual primary care over 5 years’ follow-up. This study aimed to estimate the cost-effectiveness of RAMP-DM over lifetime. Methods: We built a Discrete Event Simulation model to evaluate the cost-effectiveness of RAMP-DM over lifespan from public health service provider’s perspective. Transition probabilities among disease states were extrapolated from a cohort of 17,140 propensity score matched participants in RAMP-DM and those under usual primary care over 5-year’s follow-up. The mortality of patients with specific DM-related complications was estimated from a cohort of 206,238 patients with diabetes. Health preference and direct medical costs of DM patients referred to our previous studies among Chinese DM patients. Results: RAMP-DM individuals gained 0.745 QALYs and cost US$1404 less than those under usual care. The probabilistic sensitivity analysis found that RAMP-DM had 86.0% chance of being cost-saving compared to usual care under the assumptions and estimates used in the model. The probability of RAMP-DM being cost-effective compared to usual care would be over 99%, when the willingness to pay threshold is HK$20,000 (US$ 2564) or higher. Conclusion: RAMP-DM added to usual primary care was cost-saving in managing people with diabetes over lifetime. These findings support the integration of RAMP-DM as part of routine primary care for all patients with diabetes.-
dc.languageeng-
dc.relation.ispartofEndocrine-
dc.subjectPrimary care-
dc.subjectCost-effectiveness-
dc.subjectDiabetes mellitus-
dc.subjectMultidisciplinary-
dc.subjectRisk assessment and management-
dc.titleCost-effectiveness of a primary care multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) over lifetime-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s12020-018-1727-9-
dc.identifier.pmid30155847-
dc.identifier.scopuseid_2-s2.0-85053211120-
dc.identifier.volume63-
dc.identifier.issue2-
dc.identifier.spage259-
dc.identifier.epage269-
dc.identifier.eissn1559-0100-

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