@article{8633962,
  abstract     = {{Background: To compare estimated costs and health outcomes of lifestyle interventions for the prevention of type 2 diabetes mellitus in women who had gestational diabetes.

Methods: An age-specific Markov model was applied comparing costs and quality-adjusted life years (QALYs) of three alternatives: ‘doing nothing’; an annual reminder system (ARS) with an awareness campaign (‘ARS-awareness’); and an ARS with an intensive lifestyle intervention (‘ARS-ILS’). A healthcare payer perspective was adopted, the time horizon was 30 years and the setting was Flanders (Belgium). Sensitivity analyses were performed.

Results: ‘ARS-awareness’ was extendedly dominated. Per 10 000 participants, ‘ARS-ILS’ cost €13 210 256 more and gained 496 QALYs compared with ‘doing nothing’ (26 632 €/QALY), with a 63% probability of being cost effective, given a cost effectiveness threshold of 35 000 €/QALY. A scenario analysis showed that ‘ARS-ILS’ for 15 years only offered to women with prediabetes (compared with ‘doing nothing’) has an 89.5% likelihood of being dominant.

Conclusions: ‘ARS-ILS’ may be the preferred intervention. However, the probability of being cost effective was low. Based on further scenario analyses, we recommend healthcare decision makers to consider the application of a more intensive alternative, focused on the highest risk profiles and with a shorter intervention duration.}},
  author       = {{Werbrouck, Amber and Schmidt, Masja and Putman, Koen and Annemans, Lieven and Benhalima, Katrien and Simoens, Steven and Verhaeghe, Nick}},
  issn         = {{1101-1262}},
  journal      = {{EUROPEAN JOURNAL OF PUBLIC HEALTH}},
  keywords     = {{diabetes mellitus,type 2,gestational diabetes,cost effectiveness,costs and benefits,belgium,life style,quality-adjusted life years,reminder systems,prediabetes,health outcomes,sensitivity analysis,healthcare payer,prevention,CARDIOVASCULAR MORTALITY,ALL-CAUSE,MELLITUS,PEOPLE,CARE}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{396--401}},
  title        = {{Cost-utility analysis of lifestyle interventions to prevent type 2 diabetes in women with prior gestational diabetes}},
  url          = {{http://dx.doi.org/10.1093/eurpub/ckz196}},
  volume       = {{30}},
  year         = {{2020}},
}

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