Cost‐effectiveness of a multicomponent quality improvement care model for diabetes in South Asia: The CARRS randomized clinical trial
Authors' conclusion
In a trial setting in South Asia, a multicomponent strategy for diabetes care resulted in better multiple risk factor control at higher costs and may be cost-effective depending on the willingness to pay threshold with substantial uncertainty around cost-effectiveness for QALYs gained in the short term (2.5 years). Future research needs to confirm the long-term cost-effectiveness of intensive multifactorial intervention for diabetes care in diverse healthcare settings in LMICs.
Study context
- Population
- People with T2D in 10 urban clinics in India and Pakistan; mean age 54.2 years, median diabetes duration 7 years, mean HbA1c 9.9% (85 mmol/mol) at baseline
- Participants
- 1,146 people
- Comparison
- Multicomponent quality improvement strategy vs usual care
- Interventionn = 575
- Usual caren = 571reference
- Primary endpoint
- Incremental cost-effectiveness ratios (ICERs) per unit achievement in multiple risk factor control, per unit reduction in HbA1c, 5-mmHg SBP, 10-unit LDLc and per QALY gained (2020 PPP-adjusted Int$)
Methodological detailshealthcare system and societal perspectives, multicentre
- Healthcare system and societal perspectives
- Multicentre
Primary result
As reported in the abstract
Cost-effectiveness of intervention vs usual care
- Annual incremental cost per person, health system perspective
- Int$ 1061.9
- Annual incremental cost per person, societal perspective
- Int$ 1093.6
- ICER per increase in multiple risk factor control
- Int$ 10,874.6
- ICER per one percentage point reduction in HbA1c
- $2588.1
- ICER per 5 unit reduction in SBP (mmHg)
- $1744.6
- ICER per 10 unit reduction in LDLc (mg/dl)
- $1271
- ICER per QALY gained, societal perspective
- $33,399.6
Original publication
Cost‐effectiveness of a multicomponent quality improvement care model for diabetes in South Asia: The CARRS randomized clinical trial. Diabet Med. Published 16 March 2023. doi:10.
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