TY - JOUR
T1 - The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes
T2 - Application of a new model in India and Israel
AU - Marseille, Elliot
AU - Lohse, Nicolai
AU - Jiwani, Aliya
AU - Hod, Moshe
AU - Seshiah, Veeraswamy
AU - Yajnik, Chittaranjan S.
AU - Arora, Geeti Puri
AU - Balaji, Vijayam
AU - Henriksen, Ole
AU - Lieberman, Nicky
AU - Chen, Rony
AU - Damm, Peter
AU - Metzger, Boyd E.
AU - Kahn, James G.
N1 - Funding Information:
This study was funded in its entirety by Novo Nordisk A/S. EM, AJ and JGK were contracted by Novo Nordisk A/S to conduct this research. N Lohse is a full-time employee of Novo Nordisk A/S, and OH is a former employee. CSY received travel and accommodation support from Novo Nordisk A/S to attend a conference, and PD has provided consulting services to Novo Nordisk A/S. The authors declare no other relationships or activities that could appear to have influenced the submitted work.
PY - 2013/5
Y1 - 2013/5
N2 - Objective: Gestational diabetes mellitus (GDM) is associated with elevated risks of perinatal complications and type 2 diabetes mellitus, and screening and intervention can reduce these risks. We quantified the cost, health impact and cost-effectiveness of GDM screening and intervention in India and Israel, settings with contrasting epidemiologic and cost environments. Methods: We developed a decision-analysis tool (the GeDiForCE™) to assess cost-effectiveness. Using both local data and published estimates, we applied the model for a general medical facility in Chennai, India and for the largest HMO in Israel. We computed costs (discounted international dollars), averted disability-adjusted life years (DALYs) and net cost per DALY averted, compared with no GDM screening. Results: The programme costs per 1000 pregnant women are $259139 in India and $259929 in Israel. Net costs, adjusted for averted disease, are $194358 and $76102, respectively. The cost per DALY averted is $1626 in India and $1830 in Israel. Sensitivity analysis findings range from $628 to $3681 per DALY averted in India and net savings of $72420-8432 per DALY averted in Israel. Conclusion: GDM interventions are highly cost-effective in both Indian and Israeli settings, by World Health Organization standards. Noting large differences between these countries in GDM prevalence and costs, GDM intervention may be cost-effective in diverse settings.
AB - Objective: Gestational diabetes mellitus (GDM) is associated with elevated risks of perinatal complications and type 2 diabetes mellitus, and screening and intervention can reduce these risks. We quantified the cost, health impact and cost-effectiveness of GDM screening and intervention in India and Israel, settings with contrasting epidemiologic and cost environments. Methods: We developed a decision-analysis tool (the GeDiForCE™) to assess cost-effectiveness. Using both local data and published estimates, we applied the model for a general medical facility in Chennai, India and for the largest HMO in Israel. We computed costs (discounted international dollars), averted disability-adjusted life years (DALYs) and net cost per DALY averted, compared with no GDM screening. Results: The programme costs per 1000 pregnant women are $259139 in India and $259929 in Israel. Net costs, adjusted for averted disease, are $194358 and $76102, respectively. The cost per DALY averted is $1626 in India and $1830 in Israel. Sensitivity analysis findings range from $628 to $3681 per DALY averted in India and net savings of $72420-8432 per DALY averted in Israel. Conclusion: GDM interventions are highly cost-effective in both Indian and Israeli settings, by World Health Organization standards. Noting large differences between these countries in GDM prevalence and costs, GDM intervention may be cost-effective in diverse settings.
KW - Cost-effectiveness analysis
KW - Costs
KW - Diagnosis
KW - Gestational diabetes mellitus
KW - Management
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84876559824&partnerID=8YFLogxK
U2 - 10.3109/14767058.2013.765845
DO - 10.3109/14767058.2013.765845
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C2 - 23311860
AN - SCOPUS:84876559824
SN - 1476-7058
VL - 26
SP - 802
EP - 810
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 8
ER -
