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Randomized Controlled Trial
. 2022 Mar;46(2):165-170.
doi: 10.1016/j.jcjd.2021.08.003. Epub 2021 Aug 14.

Economic Analysis of a Diabetes Health Coaching Intervention for Adults Living With Type 2 Diabetes: A Single-Centre Evaluation From a Community-Based Randomized Controlled Trial

Daria J O'Reilly  1 , Gord Blackhouse  2 , James M Bowen  3 , Anka Brozic  4 , Pieter Agema  5 , Zubin Punthakee  6 , Natalia McInnes  6 , Hertzel C Gerstein  7 , Diana Sherifali  8
Affiliations
Randomized Controlled Trial

Economic Analysis of a Diabetes Health Coaching Intervention for Adults Living With Type 2 Diabetes: A Single-Centre Evaluation From a Community-Based Randomized Controlled Trial

Daria J O'Reilly et al. Can J Diabetes. 2022 Mar.

Abstract

Background: A recent randomized controlled trial demonstrated that a community-based, telephone-delivered diabetes health coaching intervention was effective for improving diabetes management. Our aim in this study was to determine whether this intervention is also cost-effective.

Methods: An economic evaluation, in the form of a cost-utility analysis (CUA), was used to assess the cost-effectiveness of the coaching intervention from a public payer's perspective. All direct medical costs, as well as intervention implementation, were included. The outcome measure for the CUA was quality-adjusted life-year (QALY). Uncertainty of cost-effectiveness results was estimated using nonparametric bootstraps of patient-level costs and QALYs in the coaching and control arms. A cost-effectiveness acceptability curve was used to express this uncertainty as the probability that diabetes health coaching is cost-effective across a range of values of willingness-to-pay thresholds for a QALY.

Results: The results show that subjects in the coaching arm incurred higher overall costs (in Canadian dollars) than subjects in the control arm ($1,581 vs $1,086, respectively) and incurred 0.02 more QALYs. The incremental cost-effectiveness ratio of the diabetes health coaching intervention compared with usual care was found to be $35,129 per QALY, with probabilities of 67% and 82% that diabetes health coaching would be cost-effective at a willingness-to-pay threshold of $50,000 per QALY and $100,000 per QALY, respectively.

Conclusion: A community-based, telephone-delivered diabetes health coaching intervention is cost-effective.

Keywords: accompagnement en santé; cost-effectiveness; diabète de type 2; efficience; essai comparatif à répartition aléatoire; glycated hemoglobin; health coaching; hémoglobine glyquée; randomized controlled trial; type 2 diabetes.

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