Trial reportValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2017
Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data.
Trial report in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Cost-effectiveness analysis of PSA-based mass screening: Evidence from a randomised controlled trial combined with register data.PloS one · 2019Trial
- Ten-Year Cost-Effectiveness of the Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM) Relative to Usual Care in Hong Kong Public Primary Care: A Population-Based Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial.Cost effectiveness and resource allocation : C/E · 2022Article
- Cost-effectiveness of a Stepwise Approach vs Standard Care for Diabetes Prevention in India.JAMA network open · 2020Article
- Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundThere is uncertainty about the cost effectiveness of early intensive treatment versus routine care in individuals with type 2 diabetes detected by screening.
objectivesTo derive a trial-informed estimate of the incremental costs of intensive treatment as delivered in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Europe (ADDITION) trial and to revisit the long-term cost-effectiveness analysis from the perspective of the UK National Health Service.
methodsWe analyzed the electronic primary care records of a subsample of the ADDITION-Cambridge trial cohort (n = 173). Unit costs of used primary care services were taken from the published literature. Incremental annual costs of intensive treatment versus routine care in years 1 to 5 after diagnosis were calculated using multilevel generalized linear models. We revisited the long-term cost-utility analyses for the ADDITION-UK trial cohort and reported results for ADDITION-Cambridge using the UK Prospective Diabetes Study Outcomes Model and the trial-informed cost estimates according to a previously developed evaluation framework.
resultsIncremental annual costs of intensive treatment over years 1 to 5 averaged £29.10 (standard error = £33.00) for consultations with general practitioners and nurses and £54.60 (standard error = £28.50) for metabolic and cardioprotective medication. For ADDITION-UK, over the 10-, 20-, and 30-year time horizon, adjusted incremental quality-adjusted life-years (QALYs) were 0.014, 0.043, and 0.048, and adjusted incremental costs were £1,021, £1,217, and £1,311, resulting in incremental cost-effectiveness ratios of £71,232/QALY, £28,444/QALY, and £27,549/QALY, respectively. Respective incremental cost-effectiveness ratios for ADDITION-Cambridge were slightly higher.
conclusionsThe incremental costs of intensive treatment as delivered in the ADDITION-Cambridge trial were lower than expected. Given UK willingness-to-pay thresholds in patients with screen-detected diabetes, intensive treatment is of borderline cost effectiveness over a time horizon of 20 years and more.
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