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Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms

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  • Yanshang Wang

    (Peking University
    Peking University)

  • Dan Guo

    (China Aerospace Science & Industry Corporation 731 Hospital)

  • Yiqi Xia

    (Peking University
    Peking University)

  • Mingzheng Hu

    (Peking University
    Peking University)

  • Ming Wang

    (Peking University
    Peking University)

  • Zhenyu Shi

    (Peking University
    Peking University)

  • Xiaolong Guan

    (Peking University
    Peking University)

  • Dawei Zhu

    (Peking University)

  • Ping He

    (Peking University)

Abstract

The coexistence of type 2 diabetes (T2DM) and depression is a prominent example of multimorbidity. In previous work, we reported the results of a completed cluster-randomized controlled trial that was conducted in eight community health centers in China. We enrolled adults (≥18 years) with type 2 diabetes and depressive symptoms. In the intervention group, a comprehensive care plan was developed based on the Integrated Care Model for Patients with Diabetes and Depression (CIC-PDD). In this study, we explore the cost-effectiveness of the CIC-PDD by conducting a one-year within-trial economic evaluation from the health system, multipayer and societal perspectives. Health outcomes are quality-adjusted life years (QALYs) and depression-free days (DFDs), and we calculate incremental cost-effectiveness ratios (ICERs) and cost-effectiveness probability. Among 630 participants (275 intervention, 355 usual care), the cost per QALY gained is $7,922.82, $7,823.85, and $7,409.46, with cost-effectiveness probabilities of 66.41%- 94.45%. The cost per DFD is $2.63–$2.82, requiring a willingness-to-pay of $9.00–$10.50 for >95% probability of cost-effectiveness. We find that the CIC-PDD model demonstrates cost-effectiveness within primary health care settings, but further studies are needed to assess its long-term sustainability and scalability. Trial registration: 35 ChiCTR2200065608.

Suggested Citation

  • Yanshang Wang & Dan Guo & Yiqi Xia & Mingzheng Hu & Ming Wang & Zhenyu Shi & Xiaolong Guan & Dawei Zhu & Ping He, 2025. "Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms," Nature Communications, Nature, vol. 16(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-58120-x
    DOI: 10.1038/s41467-025-58120-x
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    1. Stephen Rocks & Daniela Berntson & Alejandro Gil-Salmerón & Mudathira Kadu & Nieves Ehrenberg & Viktoria Stein & Apostolos Tsiachristas, 2020. "Cost and effects of integrated care: a systematic literature review and meta-analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1211-1221, November.
    2. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial‐based cost‐effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496, May.
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