Evidence map›Paper›PMID 38664882›Full record

ArticleJournal of diabetes2024

Cost saving analysis of prediabetes intervention modalities in comparison with inaction using Markov state transition model-A multiregional case study.

Hussain Abdulrahman Al-Omar, Marcin Czech, Tran Quang Nam, Ulrike Gottwald-Hostalek, Nikola Vesic, James Whitehouse, Maddy Dawson

Open access · goldAbstract readComparative Study
In one paragraph

Article in Journal of diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
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 4 institutions in 4 countries.

Hussain Abdulrahman Al-OmarDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.ORCID https://orcid.org/0000-0002-0765-0466
Marcin CzechPharmacoeconomic Department, Institute of Mother and Child, Warsaw, Poland.
Tran Quang NamDepartment of Endocrinology, University Medical Center, Ho Chi Minh City, Vietnam.
Ulrike Gottwald-HostalekMerck KGaA, Darmstadt, Germany.
Nikola VesicMerck doo, Belgrade, Serbia.
James WhitehouseLightning Health Ltd, London, UK.
Maddy DawsonLightning Health Ltd, London, UK.ORCID https://orcid.org/0009-0002-5033-2735
King Saud University · SAMerck (Germany) · DEMSD (Serbia) · RSUniversity Medical Center HCMC · VN

Funding

Merck KGaA, Darmstadt, Germany
6 · The paper itself

Abstract

backgroundPrediabetes management is a priority for policymakers globally, to avoid/delay type 2 diabetes (T2D) and reduce severe, costly health consequences. Countries moving from low to middle income are most at risk from the T2D "epidemic" and may find implementing preventative measures challenging; yet prevention has largely been evaluated in developed countries.

methodsMarkov cohort simulations explored costs and benefits of various prediabetes management approaches, expressed as "savings" to the public health care system, for three countries with high prediabetes prevalence and contrasting economic status (Poland, Saudi Arabia, Vietnam). Two scenarios were compared up to 15 y: "inaction" (no prediabetes intervention) and "intervention" with metformin extended release (ER), intensive lifestyle change (ILC), ILC with metformin (ER), or ILC with metformin (ER) "titration."

resultsT2D was the highest-cost health state at all time horizons due to resource use, and inaction produced the highest T2D costs, ranging from 9% to 34% of total health care resource costs. All interventions reduced T2D versus inaction, the most effective being ILC + metformin (ER) "titration" (39% reduction at 5 y). Metformin (ER) was the only strategy that produced net saving across the time horizon; however, relative total health care system costs of other interventions vs inaction declined over time up to 15 y. Viet Nam was most sensitive to cost and parameter changes via a one-way sensitivity analysis.

conclusionsMetformin (ER) and lifestyle interventions for prediabetes offer promise for reducing T2D incidence. Metformin (ER) could reduce T2D patient numbers and health care costs, given concerns regarding adherence in the context of funding/reimbursement challenges for lifestyle interventions.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsMarkov ChainsMetforminPrediabetic StateCost-Benefit AnalysisCost SavingsFemaleHealth Care CostsHumansLife StyleMaleMiddle AgedSaudi ArabiaVietnamHypoglycemic AgentsMetforminbudget impactcase studycost savingmetforminprediabetes

Identifiers

PMID38664882
PMCPMC11045917
OpenAlexW4395670185

What OpenQuestion holds

Texttitle and abstract
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.