Early economic evaluation of an intervention to improve uptake of the NHS England Diabetes Prevention Programme

ABSTRACT

Background

Despite reported increases in referral numbers, a large proportion of those with prediabetes still decline participation in the NHS England Diabetes Prevention Programme (NDPP). The aim of this study was to explore whether investment in interventions to improve uptake of the programme has the potential to be cost-effective.

Methods

An early cost-utility analysis was conducted using a Markov model parameterized based on secondary data sources. We explored different uptake scenarios and the impact that this had on the maximum allowable intervention price based on cost-effectiveness at the UK NICE willingness to pay threshold of £20,000 (US$ 25,913). Value of information analyses were conducted to explore the potential value of further research to resolve uncertainty at each uptake level.

Results

As uptake levels increase, the maximum allowable intervention price and overall expected value of removing decision uncertainty increases. For 5 percentage and 50 percentage points increase in uptake levels, the maximum allowable intervention price is £41.86 (US$ 54.23) and £418.59 (US$ 542.34) per person, and the overall expected value of removing decision uncertainty are £361,818,839 (US$ 468,786,625) and £1,468,712,316 (US$ 1,902,921,063) respectively.

Conclusion

There is headroom for investment in interventions that improve uptake to the NDPP, thereby allowing the programme itself to be delivered in a manner that remains cost-effective.

KEYWORDS:

• Early economic evaluation
• headroom analysis
• NHS Diabetes Prevention Programme
• prediabetes
• Type 2 diabetes mellitus
• value of information analysis

Acknowledgments

The research was supported by the National Institute for Health Research (NIHR) infrastructure at Leeds. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We also acknowledge the contributions from organizations (and individuals within) that formed part of the wider partnership involved in this work: Leeds City Council (Hanna Kaye, Diane Burke, Lucy Jackson); Leeds Academic Health Partnership (Paul Stewart, Sarah Brondson); Leeds GP Confederation/Leeds Community Healthcare Trust (Ruth Burnett); and Leeds Clinical Commissioning Group (Bryan Power, Jason Broch).

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

All study authors meet the criteria for authorship as outlined by the journal policy.

Complying with ethics of experimentation

Ethical approval was not needed.

Consent

Participatory consent was not needed.

Using third-party material

All figures and tables submitted are original

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

The investigator time on this study was funded by a research grant to the University of Leeds by SomaLogic Inc [116466].