IDEAS home Printed from https://ideas.repec.org/a/nat/natcom/v16y2025i1d10.1038_s41467-025-58120-x.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://www.nature.com/articles/s41467-025-58120-x
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1038/s41467-025-58120-x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eldon Spackman & Stewart Richmond & Mark Sculpher & Martin Bland & Stephen Brealey & Rhian Gabe & Ann Hopton & Ada Keding & Harriet Lansdown & Sara Perren & David Torgerson & Ian Watt & Hugh MacPherso, 2014. "Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-12, November.
    2. Abualbishr Alshreef & Allan J. Wailoo & Steven R. Brown & James P. Tiernan & Angus J. M. Watson & Katie Biggs & Mike Bradburn & Daniel Hind, 2017. "Cost-Effectiveness of Haemorrhoidal Artery Ligation versus Rubber Band Ligation for the Treatment of Grade II–III Haemorrhoids: Analysis Using Evidence from the HubBLe Trial," PharmacoEconomics - Open, Springer, vol. 1(3), pages 175-184, September.
    3. Rachael Hunter & Gianluca Baio & Thomas Butt & Stephen Morris & Jeff Round & Nick Freemantle, 2015. "An Educational Review of the Statistical Issues in Analysing Utility Data for Cost-Utility Analysis," PharmacoEconomics, Springer, vol. 33(4), pages 355-366, April.
    4. Wanrudee Isaranuwatchai & Maureen Markle-Reid & Jeffrey Hoch, 2015. "Adjusting for Baseline Covariates in Net Benefit Regression: How You Adjust Matters," PharmacoEconomics, Springer, vol. 33(10), pages 1083-1090, October.
    5. Catharine Ward Thompson & Aldo Elizalde & Steven Cummins & Alastair H. Leyland & Willings Botha & Andrew Briggs & Sara Tilley & Eva Silveirinha de Oliveira & Jenny Roe & Peter Aspinall & Richard Mitch, 2019. "Enhancing Health Through Access to Nature: How Effective are Interventions in Woodlands in Deprived Urban Communities? A Quasi-experimental Study in Scotland, UK," Sustainability, MDPI, vol. 11(12), pages 1-21, June.
    6. Iftekhar Khan & Stavros Petrou & Kamran Khan & Dipesh Mistry & Ranjit Lall & Bart Sheehan & Sarah Lamb, 2019. "Does Structured Exercise Improve Cognitive Impairment in People with Mild to Moderate Dementia? A Cost-Effectiveness Analysis from a Confirmatory Randomised Controlled Trial: The Dementia and Physical," PharmacoEconomics - Open, Springer, vol. 3(2), pages 215-227, June.
    7. Sabrina Storgaard Sørensen & Kjeld Møller Pedersen & Ulla Møller Weinreich & Lars Ehlers, 2017. "Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 413-424, June.
    8. Sabrina Gabrielle Anjara & Chiara Bonetto & Poushali Ganguli & Diana Setiyawati & Yodi Mahendradhata & Bambang Hastha Yoga & Laksono Trisnantoro & Carol Brayne & Tine Van Bortel, 2019. "Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-26, November.
    9. Matthew Franklin & James Lomas & Simon Walker & Tracey Young, 2019. "An Educational Review About Using Cost Data for the Purpose of Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 37(5), pages 631-643, May.
    10. Karen Beny & Benjamin du Sartz de Vigneulles & Florence Carrouel & Denis Bourgeois & Valérie Gay & Claude Negrier & Claude Dussart, 2022. "Haemophilia in France: Modelisation of the Clinical Pathway for Patients," IJERPH, MDPI, vol. 19(2), pages 1-14, January.
    11. Andrew H. Briggs & Patrick S. Parfrey & Nasreen Khan & Spring Tseng & Bastian Dehmel & Yumi Kubo & Glenn M. Chertow & Vasily Belozeroff, 2016. "Analyzing Health-Related Quality of Life in the EVOLVE Trial," Medical Decision Making, , vol. 36(8), pages 965-972, November.
    12. Guillaume Sekli, 2022. "A cooperative game approach to integrated healthcare," Working Papers 2022-06, CRESE.
    13. Nadia YAKHELEF & Martine AUDIBERT & Bruno PEIRERA & Antoine MONS & Emmanuel CHABERT, 2015. "Cost-utility Analysis of Vertebroplasty versus Thoracolumbosacral Orthosis in the Treatment of Traumatic Vertebral Fractures," Working Papers 201534, CERDI.
    14. Danielle Brunenberg & Gwenn Wetzels & Patricia Nelemans & Carmen Dirksen & Johan Severens & Henri Stoffers & Jan Schouten & Martin Prins & Peter Leeuw & Manuela Joore, 2007. "Cost Effectiveness of an Adherence-Improving Programme in Hypertensive Patients," PharmacoEconomics, Springer, vol. 25(3), pages 239-251, March.
    15. Paddy Gillespie & Eamon O’Shea & Andrew Murphy & Susan Smith & Mary Byrne & Molly Byrne & Margaret Cupples, 2012. "Relative cost effectiveness of the SPHERE intervention in selected patient subgroups with existing coronary heart disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 429-443, August.
    16. Wen Wan & M. Reza Skandari & Alexa Minc & Aviva G. Nathan & Parmida Zarei & Aaron N. Winn & Michael O’Grady & Elbert S. Huang, 2018. "Cost-effectiveness of Initiating an Insulin Pump in T1D Adults Using Continuous Glucose Monitoring Compared with Multiple Daily Insulin Injections: The DIAMOND Randomized Trial," Medical Decision Making, , vol. 38(8), pages 942-953, November.
    17. Nadia Yakhelef & Martine Audibert & Bruno Peirera & Antoine Mons & Emmanuel Chabert, 2015. "Cost-utility Analysis of Vertebroplasty versus Thoracolumbosacral Orthosis in the Treatment of Traumatic Vertebral Fractures," Working Papers halshs-01241824, HAL.
    18. Francisco Jódar-Sánchez & Amaia Malet-Larrea & José Martín & Leticia García-Mochón & M. López del Amo & Fernando Martínez-Martínez & Miguel Gastelurrutia-Garralda & Victoria García-Cárdenas & Daniel S, 2015. "Cost-Utility Analysis of a Medication Review with Follow-Up Service for Older Adults with Polypharmacy in Community Pharmacies in Spain: The conSIGUE Program," PharmacoEconomics, Springer, vol. 33(6), pages 599-610, June.
    19. David Meads & Andrea Marshall & Claire Hulme & Janet Dunn & Hugo Ford, 2016. "The Cost Effectiveness of Docetaxel and Active Symptom Control versus Active Symptom Control Alone for Refractory Oesophagogastric Adenocarcinoma: Economic Analysis of the COUGAR-02 Trial," PharmacoEconomics, Springer, vol. 34(1), pages 33-42, January.
    20. Ilias Goranitis & Joanna Coast & Ed Day & Alex Copello & Nick Freemantle & Emma Frew, 2017. "Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction," Medical Decision Making, , vol. 37(5), pages 498-511, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-58120-x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.nature.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.