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Cost-effectiveness analysis of lifestyle interventions for preventing kidney disease in patients with type 2 diabetes

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Abstract

Background

Lifestyle interventions in patients with type-2 diabetes contribute to reducing the incidence of chronic kidney disease. The cost-effectiveness of lifestyle interventions to prevent kidney disease in patients with type-2 diabetes remains undetermined. We aimed to develop a Markov model from a Japanese healthcare payer’s perspective focusing on the development of kidney disease in patients with type-2 diabetes and examine the cost-effectiveness of lifestyle interventions.

Methods

To develop the model, the parameters, including lifestyle intervention effect, were derived from results of the Look AHEAD trial and previously published literature. Incremental cost-effectiveness ratios (ICER) were calculated from the difference in cost and quality-adjusted life years (QALY) between lifestyle intervention and diabetes support education groups. We estimated lifetime costs and effectiveness assuming patient’s life span to be 100 years. Costs and effectiveness were discounted by 2% annually.

Results

ICER for lifestyle intervention compared to diabetes support education was JPY 1,510,838 (USD 13,031) per QALY. Cost-effectiveness acceptability curve showed that the probability that lifestyle intervention is cost-effective at the threshold of JPY 5,000,000 (USD 43,084) per QALY gained, compared to diabetes support education, is 93.6%.

Conclusions

Using a newly-developed Markov model, we illustrated that lifestyle interventions for preventing kidney disease in patients with diabetes would be more cost-effective from a Japanese healthcare payer’s perspective compared to diabetes support education. The model parameters in the Markov model must be updated to adapt to the Japanese setting.

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Acknowledgements

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Funding

This work was supported by JSPS KAKENHI Grant number 22K21133.

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Authors and Affiliations

  1. Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan

    Yuta Suzuki, Takeru Shiroiwa & Takashi Fukuda

  2. Center for Health Informatics Policy, National Institute of Public Health, Saitama, Japan

    Keika Hoshi

  3. Department of Hygiene, Kitasato University School of Medicine, Kanagawa, Japan

    Keika Hoshi

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  1. Yuta Suzuki
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  4. Takashi Fukuda
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Contributions

YS, KH, TS and TF designed the study. YS, KH, TS, and TF analyzed the data. YS, KH, TS and TF wrote the manuscript. All the authors have revised the manuscript accordingly. All authors read and approved the final manuscript.

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Correspondence to Yuta Suzuki.

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Suzuki, Y., Hoshi, K., Shiroiwa, T. et al. Cost-effectiveness analysis of lifestyle interventions for preventing kidney disease in patients with type 2 diabetes. Clin Exp Nephrol 27, 728–736 (2023). https://doi.org/10.1007/s10157-023-02357-7

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  • DOI: https://doi.org/10.1007/s10157-023-02357-7

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