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Within-Trial Cost-Effectiveness of a Structured Lifestyle Intervention in Adults With Overweight/Obesity and Type 2 Diabetes: Results From the Action for Health in Diabetes (Look AHEAD) Study.

Citation
Zhang, Ping, et al. “Within-Trial Cost-Effectiveness of a Structured Lifestyle Intervention in Adults With Overweight Obesity and Type 2 Diabetes: Results From the Action for Health in Diabetes (Look AHEAD) Study”. 2021. Diabetes Care, vol. 44, no. 1, 2021, pp. 67–74.
Center University of Alabama at Birmingham
Author Ping Zhang, Karen M Atkinson, George A Bray, Haiying Chen, Jeanne M Clark, Mace Coday, Gareth R Dutton, Caitlin Egan, Mark A Espeland, Mary Evans, John P Foreyt, Frank L Greenway, Edward W Gregg, Helen P Hazuda, James O Hill, Edward S Horton, Van S Hubbard, Peter J Huckfeldt, Sharon D Jackson, John M Jakicic, Robert W Jeffery, Karen C Johnson, Steven E Kahn, Tina Killean, William C Knowler, Mary Korytkowski, Cora E Lewis, Nisa M Maruthur, Sara Michaels, Maria G Montez, David M Nathan, Jennifer Patricio, Anne Peters, Xavier Pi-Sunyer, Henry Pownall, Bruce Redmon, Julia T Rushing, Helmut Steinburg, Thomas A Wadden, Rena R Wing, Holly Wyatt, Susan Z Yanovski, Look AHEAD Research Group
Abstract

OBJECTIVE: To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared with standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study.

RESEARCH DESIGN AND METHODS: Data were from 4,827 participants during their first 9 years of study participation from 2001 to 2012. Information on Health Utilities Index Mark 2 (HUI-2) and HUI-3, Short-Form 6D (SF-6D), and Feeling Thermometer (FT), cost of delivering the interventions, and health expenditures was collected during the study. CE was measured by incremental CE ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 U.S. dollars.

RESULTS: Over the 9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.07 and 0.15, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT.

CONCLUSIONS: Whether ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions.

Year of Publication
2021
Journal
Diabetes care
Volume
44
Issue
1
Number of Pages
67-74
Date Published
01/2021
ISSN Number
1935-5548
DOI
10.2337/dc20-0358
Alternate Journal
Diabetes Care
PMID
33168654
PMCID
PMC7783933
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