A cost-effectiveness analysis alongside trial of a digital health-supported and community pharmacy-based prediabetes management programme (PRIME Programme) in Malaysia

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2025-03-24 DOI:10.1111/dom.16350

Kah Woon Teoh BPharm, Yeji Baek PhD, Zanfina Ademi PhD, Shaun Wen Huey Lee PhD

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Abstract

Aims

This study assessed the cost-effectiveness of a digital health-supported and community pharmacy-based lifestyle intervention (PRIME) programme for individuals with prediabetes in Malaysia over a 6-month period.

Materials and Methods

A trial-based cost-effectiveness study with a 6-month time horizon was conducted. Ninety-one participants (intervention, n = 46; usual care, n = 45) across 13 community pharmacies were included. The intervention group received in-depth counselling from pharmacists, in-app prediabetes education modules and peer support, while the usual care group received counselling based on pharmacists' usual practice. The primary outcome was quality-adjusted life years (QALY). Incremental cost-effectiveness ratios (ICER) per QALY gained of the intervention were compared with usual care from healthcare and societal perspectives. Non-parametric bootstrapping was used to examine uncertainty.

Results

At 6months, the QALY achieved was 0.467 (95% CI 0.456 to 0.479) in the intervention group and 0.466 (95% CI 0.451 to 0.482) in the usual care group, resulting in a net gain of 0.005 QALY (95% CI −0.017 to 0.026) in the intervention group. The incremental healthcare and societal costs were US$6.10 (95% CI $5.33 to $6.88) and $10.69 (95% CI $6.03 to $15.35), respectively. From a healthcare perspective, the ICER per QALY gained was $1354, with a probability of 69.2% being cost-effective, while the corresponding figures were $2371 and 67.7% from a societal perspective. Results were below the willingness-to-pay threshold at $11 845 and were robust to sensitivity analyses.

Conclusion

A community pharmacy-based and digital health-supported lifestyle intervention to manage prediabetes may be cost-effective compared with usual care in Malaysia over a 6-month period.

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成本效益分析以及马来西亚数字健康支持和社区药房糖尿病前期管理方案（PRIME方案）的试验。

目的：本研究评估了数字健康支持和社区药房为基础的生活方式干预（PRIME）计划对马来西亚前驱糖尿病患者6个月期间的成本效益。材料和方法：进行了为期6个月的基于试验的成本-效果研究。91名参与者(干预，n = 46；包括13家社区药房的常规护理（n = 45）。干预组接受药师深度咨询、app内糖尿病前期教育模块和同伴支持，常规护理组接受药师常规辅导。主要终点为质量调整生命年（QALY）。从医疗保健和社会的角度比较了干预所获得的每QALY的增量成本-效果比。采用非参数自举法检测不确定性。结果：6个月时，干预组的QALY为0.467 (95% CI 0.456 ~ 0.479)，常规护理组的QALY为0.466 (95% CI 0.451 ~ 0.482)，干预组的QALY净增益为0.005 （95% CI -0.017 ~ 0.026）。增加的医疗保健和社会成本分别为6.10美元（95% CI为5.33至6.88美元）和10.69美元（95% CI为6.03至15.35美元）。从医疗保健角度来看，每个QALY获得的ICER为1354美元，具有成本效益的概率为69.2%，而从社会角度来看，相应的数字为2371美元和67.7%。结果低于11845美元的支付意愿阈值，并且对敏感性分析具有稳健性。结论：在6个月的时间里，与马来西亚的常规护理相比，以社区药房为基础和数字健康支持的生活方式干预来管理前驱糖尿病可能具有成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.