Cost-effectiveness analysis of a multidisciplinary health-care model for patients with type-2 diabetes implemented in the public sector in Mexico: A quasi-experimental, retrospective evaluation

TY - JOUR

T1 - Cost-effectiveness analysis of a multidisciplinary health-care model for patients with type-2 diabetes implemented in the public sector in Mexico

T2 - A quasi-experimental, retrospective evaluation

AU - Sosa-Rubí, S G

AU - Contreras-Loya, D

AU - Pedraza-Arizmendi, D

AU - Chivardi-Moreno, C

AU - Alarid-Escudero, F

AU - López-Ridaura, R

AU - Servan-Mori, E

AU - Molina-Cuevas, V

AU - Casales-Hernández, G

AU - Espinosa-López, C

AU - González-Roldán, J F

AU - Silva-Tinoco, R

AU - Seiglie, J

AU - Gómez-Dantés, O

N1 - Copyright © 2020 Elsevier B.V. All rights reserved.

PY - 2020/9

Y1 - 2020/9

N2 - OBJECTIVE: In 2007, the Ministry of Health (MoH) in Mexico implemented a multidisciplinary health-care model (MHC) for patients with type-2 diabetes (T2D), which has proven more effective in controlling this condition than the conventional health-care model (CHC).RESEARCH DESIGN AND METHODS: We compared the cost-effectiveness of the MHC vs. the CHC for patients with T2D using a quasi-experimental, retrospective design. Epidemiologic and cost data were obtained from a randomly selected sample of health-care units, using medical records as well as patient- and facility-level data. We modelled the cost-effectiveness of the MHC at one, 10 and 20 years using a simulation model.RESULTS: The average cumulative costs per patient at 20 years were US$4,225 for the MHC and US$4,399 for the CHC. With a willingness to pay one gross domestic product (GDP) per capita per quality-adjusted life year (QALY) (US$8,910), the incremental net benefits per patient were US$1,450 and US$3,737 at 10 and 20 years, respectively. The MHC was cost-effective from the third year onward; however, increasing coverage to 500 patients per year rendered it cost-effective at year one.CONCLUSIONS: The MHC is cost-effective at 10 and 20 years. Cost-effectiveness can be achieved in the short term by increasing MHC coverage.

AB - OBJECTIVE: In 2007, the Ministry of Health (MoH) in Mexico implemented a multidisciplinary health-care model (MHC) for patients with type-2 diabetes (T2D), which has proven more effective in controlling this condition than the conventional health-care model (CHC).RESEARCH DESIGN AND METHODS: We compared the cost-effectiveness of the MHC vs. the CHC for patients with T2D using a quasi-experimental, retrospective design. Epidemiologic and cost data were obtained from a randomly selected sample of health-care units, using medical records as well as patient- and facility-level data. We modelled the cost-effectiveness of the MHC at one, 10 and 20 years using a simulation model.RESULTS: The average cumulative costs per patient at 20 years were US$4,225 for the MHC and US$4,399 for the CHC. With a willingness to pay one gross domestic product (GDP) per capita per quality-adjusted life year (QALY) (US$8,910), the incremental net benefits per patient were US$1,450 and US$3,737 at 10 and 20 years, respectively. The MHC was cost-effective from the third year onward; however, increasing coverage to 500 patients per year rendered it cost-effective at year one.CONCLUSIONS: The MHC is cost-effective at 10 and 20 years. Cost-effectiveness can be achieved in the short term by increasing MHC coverage.

KW - Adult

KW - Aged

KW - Cost-Benefit Analysis

KW - Delivery of Health Care/economics

KW - Diabetes Mellitus, Type 2/economics

KW - Female

KW - Humans

KW - Male

KW - Mexico

KW - Middle Aged

KW - Models, Theoretical

KW - Public Sector

KW - Quality-Adjusted Life Years

KW - Retrospective Studies

U2 - 10.1016/j.diabres.2020.108336

DO - 10.1016/j.diabres.2020.108336

M3 - Article

C2 - 32755762

SN - 0168-8227

VL - 167

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 108336

ER -