ArticleBMC medicine2025
Long-term cost-effectiveness of health behaviour intervention to manage type 2 diabetes in Nepal.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Decision-analytic models in the economic evaluation of community health worker programmes globally: a systematic review.BMJ global health · 2026Pooled it
- Effectiveness of behavioral intervention programs for preventing and managing diabetes in adults: a systematic review of evidence.BMC public health · 2025Pooled it
- Chatbot-Delivered Real-Time Support to Improve HIV Self-Testing Rates: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Cost-Effectiveness of a Lifestyle and Behavioral Care Model Targeting Cardiometabolic Disease Progression.International journal of environmental research and public health · 2026Article
- Economic evaluation of school scoliosis screening in Gannan Tibetan autonomous prefecture, Gansu Province: a cost-utility analysis based on decision tree-Markov model.Frontiers in public health · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-term cost-effectiveness analyses of health behaviour interventions to effectively manage type 2 diabetes mellitus (T2DM) in low-income countries are crucial for minimising economic burden and optimising resource allocation. Therefore, this study aimed to estimate the long-term cost-effectiveness of implementing a health behaviour intervention to manage T2DM in Nepal.
methodsA Markov model in combination with a decision tree was developed to compare the costs and outcomes of the health behaviour intervention against usual care among 481 (238-intervention and 243-control) participants from healthcare system and societal perspectives. The model integrates empirical trial data, with published data to inform parameters not collected during the trial. The model estimated costs, quality-adjusted life years (QALYs) and cost-effectiveness over 5 years, 10 years, 20 years, 30 years and a lifetime time horizons with 3% annual discounting. Sub-group, scenarios, both one-way and two-way analyses and probabilistic sensitivity analyses (PSA) were performed to assess the impact of uncertainty in the model under the threshold of 3 times gross domestic product (GDP) per capita (i.e., US $4140) for Nepal.
resultsBase-case analysis with lifetime horizon showed that the health behaviour intervention compared to usual care improved QALYs by 3.88 and increased costs by US $4293 per patient, with an incremental cost-effectiveness ratio (ICER) of US $1106 per QALY gained from a healthcare system perspective. From a societal perspective, QALYs also improved by 3.88 and costs increased by US $4550, with an ICER of US $1173 per QALY gained. Furthermore, the intervention demonstrated ICERs of US $636, US $678, US $637, and US $632 per QALY gained over 5-, 10-, 20-, and 30-year time horizons, respectively, from a healthcare system perspective, and US $719, US $766, US $659, and US $716 per QALY gained from a societal perspective. In the PSA, the probability of the health behaviour intervention being cost-effective was over 57%.
conclusionsThe health behaviour intervention for managing T2DM was cost-effective over a lifetime horizon compared to usual care. To maximise its impact, this intervention should be scaled up nationwide, and future research is warranted to assess the long-term cost-effectiveness across diverse settings in low-income countries.
trial registrationAustralia and New Zealand Clinical Trial Registry (ACTRN12621000531819).
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