Evaluating the Short-Term Costs and Benefits of a Nationwide Diabetes Prevention Programme in England: Retrospective Observational Study

• DOI: 10.1007/s40258-023-00830-8
• Publication Date: 2023-10-03T07:02:02Z
• Authors: Emma McManus; Rachel Meacock; Beth Parkinson; Matt Sutton
• Keywords: Attendance; Health Economics; Health administration

Prevention programmes typically incur short-term costs and uncertain long-term benefits. We use the National Health Service (NHS) England Diabetes Programme (NHS-DPP) to investigate whether behaviour change may be cost-effective even within participation period. analysed 384,611 referrals between June 2016 March 2019. estimated NHS using implementation provider payments. used linear regressions relate utility changes number of sessions attended, based on responses five-level EQ-5D (EQ-5D-5L) at baseline final session for 18,959 participants. then calculated corresponding quality-adjusted life year (QALY) all by combining regression coefficients with observed level attendance, individuals that did not attend any programme being assumed experience zero benefit. In secondary analysis, we added weight change, recorded 18,105 participants applied predicted values missing multiple imputation chained equations. cost-per-QALY generated. Average cost per referral was £119 (standard deviation: £118; 2020 price year, UK £ Sterling). Each attended associated a 0.0042 increase in (95% confidence interval (CI): 0.0025–0.0059). This generated 1,773 QALYs across CI: 889–2,656). Cost-per-QALY £24,929 £16,635–49,720) when were excluded. Secondary analysis showed each kilogram lost 0.0034 0.0016–0.0051) 0.0025 0.0020–0.0031) increases utility, respectively. These 1,542 QALYs, £28,661 Participants experienced small gains from attendance loss during their participation. benefits alone made this low-cost potentially short-term.