Background
Aim
Methods
Model development
Costing
Cost category | Cost per capita (N = 150) | |||
---|---|---|---|---|
Intervention | Comparator | Difference | ||
Direct costs
| ||||
1. Compensation
| ZAR 488.00 | ZAR 432.00 |
ZAR 56.00
|
+13.0%
|
2. Training
| ZAR 104.00* | ZAR 0.00 |
ZAR 104.00
|
N/A
|
3. Investigations
| ZAR 850.62 | ZAR 523.06 |
ZAR 327.56
|
+62.6%
|
4. Medication & consumables
| ZAR 3 725.53 | ZAR 3 223.41 |
ZAR 502.12
|
+15.6%
|
Total direct costs
| ZAR 5 168.15 | ZAR 4 178.47 |
ZAR 989.68
|
+23.7%
|
Indirect costs
| ||||
5. Overheads
| ZAR 782.00 | ZAR 768.00 |
ZAR 14.00
|
+1.8%
|
Total costs
| ZAR 5 950.15 | ZAR 4 946.47 |
ZAR 1 003.68
|
+20.3%
|
(USD 724.74) | (USD 602.49) |
(USD 122.25)
|
Cost consequences analysis
Life table analysis
ICER and WTP analysis
Data source | Parameter | Mean value | Lower and upper uncertainty values (Ersatzoutput) | |
---|---|---|---|---|
APCSC study [28] | Hazard ratio of fatal CHD in males | 2.03% | -0.11% | 4.41% |
Hazard ratio of fatal CHD in females | 2.54% | -0.85% | 6.42% | |
Hazard ratio of fatal stroke in males | 2.00% | -1.90% | 5.13% | |
Hazard ratio of fatal stroke in females | 2.04% | -0.71% | 5.04% | |
Intervention model (UKPDS risk engine output) | Absolute risk of fatal CHD in males | 6.06% | 3.92% | 8.50% |
Absolute risk of fatal CHD in females | 3.28% | 2.21% | 4.27% | |
Absolute risk of fatal stroke in males | 0.83% | 0.76% | 0.92% | |
Absolute risk of fatal stroke in females | 0.62% | 0.54% | 0.71% | |
Comparator model (UKPDS risk engine output) | Absolute risk of fatal CHD in males | 8.74% | 5.57% | 11.66% |
Absolute risk of fatal CHD in females | 4.78% | 3.02% | 6.41% | |
Absolute risk of fatal stroke in males | 1.13% | 0.94% | 1.29% | |
Absolute risk of fatal stroke in females | 0.82% | 0.73% | 0.94% | |
Intervention model (costing) | Per capita cost | ZAR 5950 | ZAR 5401 | ZAR 6533 |
Comparator model (costing) | Per capita cost | ZAR 4946 | ZAR 4467 | ZAR 5392 |
Software and computing
Results
Costs of models
10- Year risk: Mean % (Standard Error) | Absolute risk reduction | Cost consequence | ||
---|---|---|---|---|
Intervention
|
Comparator
|
Percentage
|
Per 1% risk reduction
| |
Coronary Heart Disease (CHD)
| ||||
Males
| 9.92 (0.93) | 13.05 (1.23) | 3.13 | ZAR 320.97 |
Females
| 5.36 (0.49) | 7.11 (0.70) | 1.76 | ZAR 571.70 |
Fatal CHD
| ||||
Males
| 6.06 (0.60) | 8.74 (0.96) | 2.68 | ZAR 374.01 |
Females
| 3.28 (0.32) | 4.78 (0.55) | 1.50 | ZAR 667.19 |
Stroke
| ||||
Males
| 6.40 (0.21) | 7.12 (0.26) | 0.72 | ZAR 1397.88 |
Females
| 4.54 (0.13) | 5.05 (0.20) | 0.51 | ZAR 1960.31 |
Fatal Stroke
| ||||
Males
| 0.83 (0.03) | 1.13 (0.05) | 0.30 | ZAR 3345.60 |
Females
| 0.62 (0.03) | 0.82 (0.03) | 0.20 | ZAR 5018.40 |
Cost consequences results
Males | |||||||
---|---|---|---|---|---|---|---|
Age (X) | Reported Population | Individuals with diabetes | Individuals on intervention | ||||
A – Individuals surviving | |||||||
B – Cumulative years lived | A | B | C | A | B | C | |
C – Remaining life expectancy at age X | |||||||
25-34
| 37654 | 37 654 | 1515469 | 40.2 | 37654 | 1541953 | 41.0 |
35-44
| 116478 | 36837 | 1143011 | 31.0 | 36846 | 1169453 | 31.7 |
45-54
| 176800 | 34930 | 784172 | 22.4 | 34986 | 810293 | 23.2 |
55-64
| 170466 | 31632 | 451359 | 14.3 | 31889 | 475917 | 14.9 |
65-74
| 115191 | 23962 | 173390 | 7.2 | 24859 | 192175 | 7.7 |
75+
| 57486 | 7685 | 15155 | 2.0 | 9357 | 21094 | 2.3 |
Females
| |||||||
Age (X)
|
Reported Population
|
Individuals with diabetes
|
Individuals on intervention
| ||||
A – Individuals surviving
| |||||||
B – Cumulative years lived
|
A
|
B
|
C
|
A
|
B
|
C
| |
C – Remaining life expectancy at age X
| |||||||
25-34
| 70088 | 70088 | 3201030 | 45.7 | 70088 | 3273923 | 46.7 |
35-44
| 208972 | 68531 | 2507937 | 36.6 | 68544 | 2580762 | 37.7 |
45-54
| 284081 | 66330 | 1833631 | 27.6 | 66400 | 1906039 | 28.7 |
55-64
| 242488 | 63398 | 1184986 | 18.7 | 63693 | 1255573 | 19.7 |
65-74
| 173947 | 55288 | 591552 | 10.7 | 56402 | 655097 | 11.6 |
75+
| 114595 | 33421 | 148007 | 4.4 | 36533 | 190422 | 5.2 |