Table 3.
Sensitivity analyses modeling cost-effectiveness of interventions
Sensitivity analysis scenario | EUC | CHW only | CHW + PL | CHW + PL vs. CHW only | CHW only vs. EUC | CHW + PL vs. EUC |
---|---|---|---|---|---|---|
18-month intervention with persistent intervention benefits | ||||||
Total cost1 ($) | ||||||
10 years | 70,851 | 70,878 | 69,985 | –893 | 27 | –866 |
20 years | 124,401 | 124,265 | 122,467 | –1,798 | –135 | –1,933 |
30 years | 159,312 | 159,367 | 157,491 | –1,876 | 54 | –1,822 |
QALE (QALYs) | ||||||
10 years | 4.48 | 4.49 | 4.51 | 0.0234 | 0.0051 | 0.0286 |
20 years | 7.14 | 7.16 | 7.23 | 0.0714 | 0.0206 | 0.0919 |
30 years | 8.58 | 8.61 | 8.73 | 0.1183 | 0.0348 | 0.1532 |
Cost per QALY gained ($) | ||||||
10 years | Cost saving | 5,148 | Cost saving | |||
20 years | Cost saving | Cost saving | Cost saving | |||
30 years | Cost saving | 1,570 | Cost saving | |||
Ongoing intervention with persistent intervention benefits | ||||||
Total cost2 ($) | ||||||
10 years | 70,851 | 71,252 | 70,545 | –706 | 400 | –306 |
20 years | 124,401 | 124,867 | 123,371 | –1,497 | 467 | –1,029 |
30 years | 159,312 | 160,109 | 158,604 | –1,505 | 796 | –709 |
QALE (QALYs) | ||||||
10 years | 4.48 | 4.49 | 4.51 | 0.0234 | 0.0051 | 0.0286 |
20 years | 7.14 | 7.16 | 7.23 | 0.0714 | 0.0206 | 0.0919 |
30 years | 8.58 | 8.61 | 8.73 | 0.1183 | 0.0348 | 0.1532 |
Cost per QALY gained ($) | ||||||
10 years | Cost saving | 78,148 | Cost saving | |||
20 years | Cost saving | 22,719 | Cost saving | |||
30 years | Cost saving | 22,862 | Cost saving |
Total cost was a combination of the intervention cost and outcome cost. The intervention cost was $234, $820, and $1,599 per participant for the EUC, CHW-only, and CHW + PL interventions, respectively, over the 18-month intervention period of the REACH Detroit trial. The outcome cost derived from the direct medical costs of diabetes and its complications was estimated by the MMD.
Total cost was a combination of the intervention cost and outcome cost. The intervention cost was $234, $820, and $1,599 per participant for the EUC, CHW-only, and CHW + PL interventions, respectively, over the 18-month intervention period of the REACH Detroit trial. The ongoing intervention cost per participant per year was $43.80 and $65.70 for the CHW-only and CHW + PL interventions over the simulation period, respectively, assuming that a total of 2 h per participant per year was made by the CHW or PL to make contact with the participants. The ongoing cost would support the ongoing CHW-only and CHW + PL interventions to maintain the trial-observed intervention effects over the simulation time horizon. The outcome cost derived from the direct medical costs of diabetes and its complications was estimated by the MMD.