The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: application of a new model in India and Israel - PubMed (original) (raw)

doi: 10.3109/14767058.2013.765845. Epub 2013 Feb 14.

Nicolai Lohse, Aliya Jiwani, Moshe Hod, Veeraswamy Seshiah, Chittaranjan S Yajnik, Geeti Puri Arora, Vijayam Balaji, Ole Henriksen, Nicky Lieberman, Rony Chen, Peter Damm, Boyd E Metzger, James G Kahn

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The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: application of a new model in India and Israel

Elliot Marseille et al. J Matern Fetal Neonatal Med. 2013 May.

Abstract

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 259,139inIndiaand259,139 in India and 259,139inIndiaand259,929 in Israel. Net costs, adjusted for averted disease, are 194,358and194,358 and 194,358and76,102, respectively. The cost per DALY averted is 1626inIndiaand1626 in India and 1626inIndiaand1830 in Israel. Sensitivity analysis findings range from 628to628 to 628to3681 per DALY averted in India and net savings of $72,420-8432 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.

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