A cost-effectiveness analysis of the Prediabetes Intervention Package (PIP) in primary care: a New Zealand pilot programme
Connor, D.; Coppell, K.; Gray, A.; Sullivan, T.
New Zealand Medical Journal 132(1504): 24-34
2019
ISSN/ISBN: 0028-8446 PMID: 31647792 Document Number: 699637
To estimate the cost-effectiveness of the Prediabetes Intervention Package (PIP), a multilevel primary care nurse-delivered prediabetes lifestyle intervention programme was piloted in Hawke's Bay, New Zealand. The goal of the intervention was weight loss and prevention of progression from prediabetes to type 2 diabetes. A cost-effectiveness evaluation was conducted from a health funder perspective using 2015 NZ$ with costs and per kilogram (kg) weight change at six months analysed at an individual participant level. Missing six-month data were imputed using multiple imputation adjusted for baseline characteristics. Change in weight was calculated following intention-to-treat principles. Three lower-cost scenarios were modelled. Using multiple imputation and bootstrapping, there was a statistically significant median difference in weight between the intervention and control groups of 1.87kg (95% CI 0.54, 3.15) at six months. The incremental cost-effectiveness ratio (ICER) was NZ$170.90 (95% CI 100.37, 553.93) per 1kg of weight loss. ICERs for the lower-cost scenarios ranged from NZ$95.33 (95% CI 56.12, 308.36) to $NZ120.74 (95% CI 71.04, 391.60). The primary care nurse-delivered PIP intervention is likely to be a cost-effective weight loss strategy for preventing or delaying progression to type 2 diabetes in people with prediabetes.