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Comparing the Cost-effectiveness of the Diabetes Prevention Program and Plant Based Diet: Prevention of type 2 diabetes among overweight and obese – A Markov model
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2018 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Non-communicable diseases, including diabetes, presents a great burden in developing and developed world, especially in older adults and seniors. In Europe, approximately 9% of the adults have diabetes. In 2017 the diabetes-related costs in Sweden was $ 8 356/capita. Health Economic Evaluations indicates great health- and economic burden due to type 2 diabetes, which is the most common obesity-related comorbidity. Dietary habits and body weight plays an important role in the question which dietary pattern best addresses glycaemia, weight control, and cardiovascular risk factors. Individuals following a vegetarian and vegan diet have lower levels of cholesterol and body mass index, which consequentially decrease the risk of diabetes.

Aim: The objective of this study was to estimate the cost-effectiveness of type 2 diabetes prevention initiative targeting decreasing risk of developing type 2 diabetes with a plant-based diet, in individuals in prediabetic states, by comparing a hypothetical plant-based diet intervention versus a lifestyle intervention in Diabetes Prevention Program.

Methods: Markov model with states prediabetes, diabetes, and death is applied. It is modelled from a societal perspective for a 10-year time horizon. Utility units are expressed in Quality Adjusted Life Years (QALYs), and costs in USD ($) at 2018 inflation rate. A 3% discount rate is applied on both costs and benefits, to reflect the time preference of the society on future investments. The incremental cost-effectiveness ratio (ICER) per QALY gained was calculated to show whether the hypothetical Plant-based Diet program is cost-effective, compare to Lifestyle Diabetes Prevention Program.

Results: Incremental cost-effectiveness ratios identify Plant-based Diet as pricier with a cost of $ 89 956, but it also yielded QALYs of 6.72. The lifestyle DPP brings 5.63 QALYs for the cost of $ 88 560. The incremental effect recognizes 1.08 higher QALY of Plant-based Diet over Lifestyle Diabetes Prevention Program. The Plant-based intervention yielded grater QALYs in this analysis, with and ICER cost per QALY of $ 1 297.

Conclusion: Plant-based Diet Program yield greater health benefits and cost-effectiveness compared to Lifestyle Diabetes Prevention Program. Yet, further research is needed to gather more accurate data to validate the effectiveness.

Place, publisher, year, edition, pages
2018. , p. 32
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2018:29
Keywords [en]
Pre-diabetes, Diabetes, Obesity, Dietary pattern, Plant-based diet, Cost-effectiveness, Markov model
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-152716OAI: oai:DiVA.org:umu-152716DiVA, id: diva2:1257339
Educational program
Master's Programme in Public Health
Presentation
2018-05-23, Caring Science building, Room A110, Umeå University, Umeå, 09:00 (English)
Supervisors
Examiners
Available from: 2018-10-22 Created: 2018-10-19 Last updated: 2018-10-22Bibliographically approved

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CiteExportLink to record
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Citation style
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