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Cost and Cost-effectiveness of Large-scale Screening for Type 1 Diabetes in Colorado.
- Source :
-
Diabetes Care . Jul2020, Vol. 43 Issue 7, p1496-1503. 8p. - Publication Year :
- 2020
-
Abstract
- <bold>Objective: </bold>To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) program, a large-scale, presymptomatic type 1 diabetes screening program for children and adolescents in the metropolitan Denver region.<bold>Research Design and Methods: </bold>We report the resource utilization, costs, and effectiveness measures from the ongoing ASK program compared with usual care (i.e., no screening). Additionally, we report a practical screening scenario by including utilization and costs relevant to routine screening in clinical practice. Finally, we project the potential cost-effectiveness of ASK and routine screening by identifying clinical benchmarks (i.e., diabetic ketoacidosis [DKA] events avoided, HbA1c improvements vs. no screening) needed to meet value thresholds of $50,000-$150,000 per quality-adjusted life-year (QALY) gained over a lifetime horizon.<bold>Results: </bold>Cost per case detected was $4,700 for ASK screening and $14,000 for routine screening. To achieve value thresholds of $50,000-$150,000 per QALY gained, screening costs would need to be offset by cost savings through 20% reductions in DKA events at diagnosis in addition to 0.1% (1.1 mmol/mol) improvements in HbA1c over a lifetime compared with no screening for patients who develop type 1 diabetes. Value thresholds were not met from avoiding DKA events alone in either scenario.<bold>Conclusions: </bold>Presymptomatic type 1 diabetes screening may be cost-effective in areas with a high prevalence of DKA and an infrastructure facilitating screening and monitoring if the benefits of avoiding DKA events and improved HbA1c persist over long-run time horizons. As more data are collected from ASK, the model will be updated with direct evidence on screening effects. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TYPE 1 diabetes
*COST effectiveness
*DIABETIC acidosis
*TIME perspective
Subjects
Details
- Language :
- English
- ISSN :
- 01495992
- Volume :
- 43
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Diabetes Care
- Publication Type :
- Academic Journal
- Accession number :
- 143848844
- Full Text :
- https://doi.org/10.2337/dc19-2003