IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0107225.html
   My bibliography  Save this article

Evaluating the Cost-Effectiveness of Lifestyle Modification versus Metformin Therapy for the Prevention of Diabetes in Singapore

Author

Listed:
  • May Ee Png
  • Joanne Su-Yin Yoong

Abstract

Background: In Singapore, as diabetes is an increasingly important public health issue, the cost-effectiveness of pursuing lifestyle modification programs and/or alternative prevention strategies is of critical importance for policymakers. While the US Diabetes Prevention Program (DPP) compared weight loss through lifestyle modification with oral treatment of diabetes drug metformin to prevent/delay the onset of type 2 diabetes in pre-diabetic subjects, no data on either the actual or potential cost effectiveness of such a program is available for East or South-east Asian populations. This study estimates the 3-year cost-effectiveness of lifestyle modification and metformin among pre-diabetic subjects from a Singapore health system and societal perspective. Methodology: Cost effectiveness was analysed from 2010–2012 using a decision-based model to estimate the rates of getting diabetes, healthcare costs and health-related quality of life. Cost per quality-adjusted life year (QALY) was estimated using costs relevant to the time horizon of the study from Singapore. All costs are expressed in 2012 US dollars. Principal Findings: The total economic cost for non-diabetic subjects from the societal perspective was US$25,867, US$28,108 and US$26,177 for placebo, lifestyle modification and metformin intervention respectively. For diabetic patients, the total economic cost from the societal perspective was US$32,921, US$35,163 and US$33,232 for placebo, lifestyle modification and metformin intervention respectively. Lifestyle modification relative to placebo is likely to be associated with an incremental cost per QALY gained at US$36,663 while that of metformin intervention is likely to be US$6,367 from a societal perspective. Conclusion: Based on adaptation of the DPP data to local conditions, both lifestyle modification and metformin intervention are likely to be cost-effective and worth implementing in Singapore to prevent or delay the onset of type 2 diabetes. However, the cost of lifestyle modification from the societal perspective would have to be reduced in order to match the cost-effectiveness of metformin intervention.

Suggested Citation

  • May Ee Png & Joanne Su-Yin Yoong, 2014. "Evaluating the Cost-Effectiveness of Lifestyle Modification versus Metformin Therapy for the Prevention of Diabetes in Singapore," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-8, September.
    • Handle: RePEc:plo:pone00:0107225
    DOI: 10.1371/journal.pone.0107225
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0107225
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0107225&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0107225?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. Carrasco, Luis R & Lee, Linda K & Lee, Vernon J & Ooi, Eng Eong & Shepard, Donald S & Thein, Tun L & Gan, Victor & Cook, Alex R & Lye, David & Ng, Lee Ching & Leo, Yee Sin, 2011. "Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore," MPRA Paper 57761, University Library of Munich, Germany.
    2. Richard J. Willke & Henry A. Glick & Daniel Polsky & Kevin Schulman, 1998. "Estimating country‐specific cost‐effectiveness from multinational clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 481-493, September.
    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. Eunha Shim, 2017. "Cost-effectiveness of dengue vaccination in Yucatán, Mexico using a dynamic dengue transmission model," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-17, April.
    2. Richard Grieve & Richard Nixon & Simon G. Thompson & Charles Normand, 2005. "Using multilevel models for assessing the variability of multinational resource use and cost data," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 185-196, February.
    3. Gerhart Knerer & Christine S M Currie & Sally C Brailsford, 2020. "The economic impact and cost-effectiveness of combined vector-control and dengue vaccination strategies in Thailand: results from a dynamic transmission model," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(10), pages 1-32, October.
    4. Donald S Shepard & Eduardo A Undurraga & Yara A Halasa, 2013. "Economic and Disease Burden of Dengue in Southeast Asia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(2), pages 1-12, February.
    5. Moreno, Elías & Girón, F.J. & Vázquez-Polo, F.J. & Negrín, M.A., 2012. "Optimal healthcare decisions: The importance of the covariates in cost–effectiveness analysis," European Journal of Operational Research, Elsevier, vol. 218(2), pages 512-522.
    6. Thompson, Simon G. & Nixon, Richard M. & Grieve, Richard, 2006. "Addressing the issues that arise in analysing multicentre cost data, with application to a multinational study," Journal of Health Economics, Elsevier, vol. 25(6), pages 1015-1028, November.
    7. Fitzner, Karen A. & Shortridge, K. F. & McGhee, S. M. & Hedley, A. J., 2001. "Cost-effectiveness study on influenza prevention in Hong Kong," Health Policy, Elsevier, vol. 56(3), pages 215-234, June.
    8. Andrew R. Willan & Matthew E. Kowgier, 2008. "Cost‐effectiveness analysis of a multinational RCT with a binary measure of effectiveness and an interacting covariate," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 777-791, July.
    9. Castillo-Riquelme, Marianela & Chalabi, Zaid & Lord, Joanne & Guhl, Felipe & Campbell-Lendrum, Diarmid & Davies, Clive & Fox-Rushby, Julia, 2008. "Modelling geographic variation in the cost-effectiveness of control policies for infectious vector diseases: The example of Chagas disease," Journal of Health Economics, Elsevier, vol. 27(2), pages 405-426, March.
    10. Andrea Manca & Nigel Rice & Mark J. Sculpher & Andrew H. Briggs, 2005. "Assessing generalisability by location in trial‐based cost‐effectiveness analysis: the use of multilevel models," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 471-485, May.
    11. Andrew R. Willan & Eleanor M. Pinto & Bernie J. O'Brien & Padma Kaul & Ron Goeree & Larry Lynd & Paul W. Armstrong, 2005. "Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT‐3 economic analysis," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 327-338, April.
    12. Ong, Suan Ee & Tyagi, Shilpa & Lim, Jane Mingjie & Chia, Kee Seng & Legido-Quigley, Helena, 2018. "Health systems reforms in Singapore: A qualitative study of key stakeholders," Health Policy, Elsevier, vol. 122(4), pages 431-443.
    13. Sarah Wordsworth & Anne Ludbrook, 2005. "Comparing costing results in across country economic evaluations: the use of technology specific purchasing power parities," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 93-99, January.
    14. Eduardo A Undurraga & Yara A Halasa & Donald S Shepard, 2013. "Use of Expansion Factors to Estimate the Burden of Dengue in Southeast Asia: A Systematic Analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(2), pages 1-15, February.
    15. Andrew Briggs, 2003. "Statistical Methods for Cost-Effectiveness Research: A Guide to Current Issues and Future Developments," Monograph 000485, Office of Health Economics.
    16. Le T P Nghiem & Tarek Soliman & Darren C J Yeo & Hugh T W Tan & Theodore A Evans & John D Mumford & Reuben P Keller & Richard H A Baker & Richard T Corlett & Luis R Carrasco, 2013. "Economic and Environmental Impacts of Harmful Non-Indigenous Species in Southeast Asia," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-9, August.
    17. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    18. Koopmanschap, Marc A. & Touw, Karien C. R. & Rutten, Frans F. H., 2001. "Analysis of costs and cost-effectiveness in multinational trials," Health Policy, Elsevier, vol. 58(2), pages 175-186, November.
    19. Richard M. Nixon & Simon G. Thompson, 2005. "Methods for incorporating covariate adjustment, subgroup analysis and between‐centre differences into cost‐effectiveness evaluations," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1217-1229, December.
    20. Christopher Fitzpatrick & Alexander Haines & Mathieu Bangert & Andrew Farlow & Janet Hemingway & Raman Velayudhan, 2017. "An economic evaluation of vector control in the age of a dengue vaccine," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 11(8), pages 1-27, August.

    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:plo:pone00:0107225. 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: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    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.