Evidence map›Paper›PMID 34482831›Full record

ArticleBMC health services research2021

Pharmacy-based screening to detect persons at elevated risk of type 2 diabetes: a cost-utility analysis.

Kari Jalkanen, Emma Aarnio, Piia Lavikainen, Jaana Lindström, Markku Peltonen, Tiina Laatikainen, Janne Martikainen

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. A mixed-methods approach to understanding pharmacists' experiences with the CANRISK diabetes risk questionnaire and user guide.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2026
    Article
  3. Article
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Kari JalkanenFaculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. kari.jalkanen@uef.fi.
Emma AarnioFaculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
Piia LavikainenFaculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
Jaana LindströmDepartment of Public Health Solutions, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
Markku PeltonenDepartment of Public Health Solutions, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
Tiina LaatikainenInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Faculty of Medicine, P.O. Box 1627, 70211, Kuopio, Finland.
Janne MartikainenFaculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
University of Eastern Finland · FIFinnish Institute for Health and Welfare · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly identification of people at elevated risk of type 2 diabetes (T2D) is an important step in preventing or delaying its onset. Pharmacies can serve as a significant channel to reach these people. This study aimed to assess the potential health economic impact of screening and recruitment services in pharmacies in referring people to preventive interventions.

methodsA decision analytic model was constructed to perform a cost-utility analysis of the expected national health economic consequences (in terms of costs and quality-adjusted life years, QALYs) of a hypothetical pharmacy-based service where people screened and recruited through pharmacies would participate in a digital lifestyle program. Cost-effectiveness was considered in terms of net monetary benefit (NMB). In addition, social return on investment (SROI) was calculated as the ratio of the intervention and recruitment costs and the net present value of expected savings. Payback time was the time taken to reach the break-even point in savings. In the base scenario, a 20-year time horizon was applied. Probabilistic and deterministic sensitivity analyses were applied to study robustness of the results.

resultsIn the base scenario, the expected savings from the pharmacy-based screening and recruitment among the reached target cohort were 255.3 m€ (95% CI - 185.2 m€ to 717.2 m€) in pharmacy visiting population meaning 1412€ (95% CI - 1024€ to 3967€) expected savings per person. Additionally, 7032 QALYs (95% CI - 1344 to 16,143) were gained on the population level. The intervention had an NMB of 3358€ (95% CI - 1397€ to 8431€) using a cost-effectiveness threshold of 50,000 €/QALY. The initial costs were 122.2 m€ with an SROI of 2.09€ (95% CI - 1.52€ to 5.88€). The expected payback time was 10 and 8 years for women and men, respectively. Results were most sensitive for changes in effectiveness of the intervention and selected discount rate.

conclusionsT2D screening and recruitment to prevention programs conducted via pharmacies was a dominant option providing both cost savings and QALY gains. The highest savings can be potentially reached by targeting recruitment at men at elevated risk of T2D.

Indexed as

Diabetes Mellitus, Type 2PharmaciesPharmacyCost-Benefit AnalysisFemaleHumansMaleQuality-Adjusted Life YearsCost effectiveness analysisMarkov modelPharmacyType 2 diabetes

Identifiers

PMID34482831
PMCPMC8418722
OpenAlexW3197111344

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.