Evidence map›Paper›PMID 38252592›Full record

ArticleHealth policy and planning2024

Extended cost-effectiveness analysis of interventions to improve uptake of diabetes services in South Africa.

Heather L Fraser, Isabelle Feldhaus, Ijeoma P Edoka, Alisha N Wade, Ciaran N Kohli-Lynch, Karen Hofman, Stéphane Verguet

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In one paragraph

Article in Health policy and planning, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
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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.

Heather L FraserHealth Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building (Level 3), 90 Byres Road, United Kingdom.ORCID 0000-0002-7100-571X
Isabelle FeldhausDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.ORCID 0000-0002-3170-3978
Ijeoma P EdokaHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 32 Princess of Wales Terrace, Johannesburg 2193, South Africa.
Alisha N WadeMRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Johannesburg 2193, South Africa.
Ciaran N Kohli-LynchSA MRC/Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Johannesburg 2193, South Africa.
Karen HofmanSA MRC/Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Johannesburg 2193, South Africa.
Stéphane VerguetDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.

Funding

Endocrine and metabolic diseases in rural South Africa-establishing burden and improving detectionK43TW010698 · FIC · WITS HEALTH CONSORTIUM (PTY), LTD · PI WADE, ALISHA NICOLE · 2017 to 2021
$581k
FIC NIH HHS K43 TW010698
6 · The paper itself

Abstract

The rising prevalence of diabetes in South Africa (SA), coupled with significant levels of unmet need for diagnosis and treatment, results in high rates of diabetes-associated complications. Income status is a determinant of utilization of diagnosis and treatment services, with transport costs and loss of wages being key barriers to care. A conditional cash transfer (CCT) programme, targeted to compensate for such costs, may improve service utilization. We applied extended cost-effectiveness analysis (ECEA) methods and used a Markov model to compare the costs, health benefits and financial risk protection (FRP) attributes of a CCT programme. A population was simulated, drawing from SA-specific data, which transitioned yearly through various health states, based on specific probabilities obtained from local data, over a 45-year time horizon. Costs and disability-adjusted life years (DALYs) were applied to each health state. Three CCT programme strategies were simulated and compared to a 'no programme' scenario: (1) covering diagnosis services only; (2) covering treatment services only; (3) covering both diagnosis and treatment services. Cost-effectiveness was reported as incremental net monetary benefit (INMB) using a cost-effectiveness threshold of USD3015 per DALY for SA, while FRP outcomes were reported as catastrophic health expenditure (CHE) cases averted. Distributions of the outcomes were reported by income quintile and sex. Covering both diagnosis and treatment services for the bottom two quintiles resulted in the greatest INMB (USD22 per person) and the greatest CHE cases averted. There were greater FRP benefits for women compared to men. A CCT programme covering diabetes diagnosis and treatment services was found to be cost-effective, when provided to the poorest 40% of the SA population. ECEA provides a useful platform for including equity considerations to inform priority setting and implementation policies in SA.

Indexed as

Cost-Effectiveness AnalysisDiabetes MellitusCost-Benefit AnalysisFemaleHealth ExpendituresHumansIncomeMaleSouth Africacost-effectiveness analysisEconomic evaluationequitynon-communicable disease

Identifiers

PMID38252592
PMCPMC10929771

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Registered trials

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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.