<b>OBJECTIVE </b>To assess
the cost-effectiveness (CE) of an intensive lifestyle
intervention (ILI) compared to 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.
<p><b>RESEARCH DESIGN AND METHODS</b> Data were from 4,827
participants during the first 9 years of the study from 2001 to 2012. Information
on Health Utility Index-2 and -3, SF-6D, and Feeling Thermometer [FT]), cost of
delivering the interventions, and health expenditures were collected during the
study. CE was measured by incremental cost-effectiveness ratios (ICERs) in costs
per quality-adjusted life year (QALY). Future costs and QALYs were discounted
at 3% annually. Costs were in 2012 US dollars. </p>
<p><b>RESULTS </b><a>Over the </a>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
0.17 and 0.16, 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. </p>
<p><b>Conclusions </b>Whether<b> </b>ILI was cost-effective over the 9-year period is unclear because different
health utility measures led to different conclusions. </p>
Within-Trial Cost-Effectiveness of Lifestyle Intervention or Metformin for the Primary Prevention of Type 2 Diabetes
