scholarly journals Cost-effectiveness of Community-Based Depression Interventions for Rural and Urban Adults With Type 2 Diabetes: Projections From Program ACTIVE (Adults Coming Together to Increase Vital Exercise) II

2021 ◽  
Author(s):  
Shihchen Kuo ◽  
Wen Ye ◽  
Mary de Groot ◽  
Chandan Saha ◽  
Jay H. Shubrook ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Behavioral Therapy ◽  
Intervention Strategy ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Healthcare Sector ◽  
Community Based

<b>Objective: </b>We estimated the cost-effectiveness of the Program ACTIVE II community-based exercise (EXER), cognitive behavioral therapy (CBT), and EXER+CBT interventions in adults with type 2 diabetes and depression relative to UC and each other. <p><b>Research Design and Methods: </b>Data were integrated into the Michigan Model for Diabetes to estimate cost and health outcomes over a 10-year simulation time horizon from the healthcare sector and societal perspectives, discounting costs and benefits at 3% annually. Primary outcome was cost per quality-adjusted life-year (QALY) gained.</p> <p><b>Results</b>: From the healthcare sector perspective, the EXER intervention strategy saved $313 per patient and produced 0.38 more QALY (cost-saving), the CBT intervention strategy cost $596 more and gained 0.29 more QALY ($2,058/QALY), and the EXER+CBT intervention strategy cost $403 more and gained 0.69 more QALY ($585/QALY) compared to UC. Both EXER and EXER+CBT interventions dominated the CBT intervention. Compared to EXER, the EXER+CBT intervention strategy cost $716 more and gained 0.31 more QALY ($2,323/QALY). From the societal perspective, compared to UC, the EXER intervention strategy saved $126 (cost-saving), the CBT intervention strategy cost $2,838/QALY, and the EXER+CBT intervention strategy cost $1,167/QALY. Both EXER and EXER+CBT interventions still dominated the CBT intervention. Compared to EXER, the EXER+CBT intervention strategy cost $3,021/QALY. Results were robust in sensitivity analyses.</p> <p><b>Conclusions: </b>All three Program ACTIVE II interventions represented a good value for money compared to UC. The EXER+CBT intervention was highly cost-effective or cost-saving compared to the CBT or EXER interventions.</p>

scholarly journals Cost-effectiveness of Community-Based Depression Interventions for Rural and Urban Adults With Type 2 Diabetes: Projections From Program ACTIVE (Adults Coming Together to Increase Vital Exercise) II

2021 ◽  
Author(s):  
Shihchen Kuo ◽  
Wen Ye ◽  
Mary de Groot ◽  
Chandan Saha ◽  
Jay H. Shubrook ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Behavioral Therapy ◽  
Intervention Strategy ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Healthcare Sector ◽  
Community Based

<b>Objective: </b>We estimated the cost-effectiveness of the Program ACTIVE II community-based exercise (EXER), cognitive behavioral therapy (CBT), and EXER+CBT interventions in adults with type 2 diabetes and depression relative to UC and each other. <p><b>Research Design and Methods: </b>Data were integrated into the Michigan Model for Diabetes to estimate cost and health outcomes over a 10-year simulation time horizon from the healthcare sector and societal perspectives, discounting costs and benefits at 3% annually. Primary outcome was cost per quality-adjusted life-year (QALY) gained.</p> <p><b>Results</b>: From the healthcare sector perspective, the EXER intervention strategy saved $313 per patient and produced 0.38 more QALY (cost-saving), the CBT intervention strategy cost $596 more and gained 0.29 more QALY ($2,058/QALY), and the EXER+CBT intervention strategy cost $403 more and gained 0.69 more QALY ($585/QALY) compared to UC. Both EXER and EXER+CBT interventions dominated the CBT intervention. Compared to EXER, the EXER+CBT intervention strategy cost $716 more and gained 0.31 more QALY ($2,323/QALY). From the societal perspective, compared to UC, the EXER intervention strategy saved $126 (cost-saving), the CBT intervention strategy cost $2,838/QALY, and the EXER+CBT intervention strategy cost $1,167/QALY. Both EXER and EXER+CBT interventions still dominated the CBT intervention. Compared to EXER, the EXER+CBT intervention strategy cost $3,021/QALY. Results were robust in sensitivity analyses.</p> <p><b>Conclusions: </b>All three Program ACTIVE II interventions represented a good value for money compared to UC. The EXER+CBT intervention was highly cost-effective or cost-saving compared to the CBT or EXER interventions.</p>

scholarly journals The cost–effectiveness of oral semaglutide versus empagliflozin in Type 2 diabetes in Denmark

2021 ◽  
Author(s):  
Lars H Ehlers ◽  
Mark Lamotte ◽  
Mafalda C Ramos ◽  
Susanne Sandgaard ◽  
Pia Holmgaard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Duration Of Treatment ◽  
Diabetes Model ◽  
Life Years ◽  
The Cost

Aim: To evaluate the cost–effectiveness of oral semaglutide+metformin versus empagliflozin+metformin in people with Type 2 diabetes uncontrolled on msetformin alone. Materials and methods: The IQVIA Core Diabetes Model was populated with efficacy data from a head-to-head study between oral semaglutide+metformin and empagliflozin+metformin. Danish costs and quality-of-life data were sourced from literature. Price per day was Danish Krone (DKK) 25.53 for oral semaglutide and DKK11.40 for empagliflozin. Discounting was fixed at 4%. Scenario and sensitivity analyses were performed. Results: Over a lifetime, Core Diabetes Model projected 8.78 and 8.75 quality-adjusted life-years and a total cost of DKK 447,633 and DKK 387,786; thereby, generating an incremental cost–effectiveness ratio of DKK 1,930,548 for oral semaglutide+metformin versus empagliflozin+metformin. Scenario and sensitivity analyses showed the robustness of the outcomes. Duration of treatment with oral semaglutide is the key driver of the analyses. Conclusion: Oral semaglutide+metformin seems not cost-effective versus empagliflozin+metformin in patients uncontrolled on metformin in Denmark.

scholarly journals Cost-effectiveness of GLP-1 receptor agonists versus insulin for the treatment of type 2 diabetes: a real-world study and systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chen-Yi Yang ◽  
Ying-Ren Chen ◽  
Huang-Tz Ou ◽  
Shihchen Kuo
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Real World ◽  
Cost Effective ◽  
Injection Therapy ◽  
Healthcare Sector ◽  
All Cause Mortality ◽  
Diabetes Patients

Abstract Background To conduct a real-word-study-based cost-effectiveness analysis of a GLP-1 receptor agonist (GLP-1RA) versus insulin among type 2 diabetes patients requiring intensified injection therapy and a systematic review of cost-effectiveness studies of GLP-1RAs versus insulin. Methods Individual-level analyses incorporating real-world effectiveness and cost data were conducted for a cohort of 1022 propensity-score-matched pairs of GLP-1RA and insulin users from Taiwan’s National Health Insurance Research Database, 2007–2016. Study outcomes included the number needed to treat (NNT) to prevent one case of clinical events, healthcare costs, and cost per case of event prevented. Costs were in 2019 US dollars. Analyses were performed from a third-party payer and healthcare sector perspectives. Structured systematic review procedures were conducted to synthesize updated evidence on the cost-effectiveness of GLP-1RAs versus insulin. Results Over a mean follow-up of 2.3 years, the NNT using a GLP-1RA versus insulin to prevent one case of all-cause mortality and hospitalized hypoglycemia was 57 and 30, respectively. Using GLP-1RAs instead of insulin cost US$54,851 and US$29,115 per case of all-cause mortality and hospitalized hypoglycemia prevented, respectively, from the payer perspective, and saved US$19,391 and US$10,293, respectively, from the healthcare sector perspective. Sensitivity analyses showed that the probability of using GLP-1RAs versus insulin being cost-effective for preventing one case of all-cause mortality or hospitalized hypoglycemia ranged from 60 to 100%. The systematic review revealed a cost-effective profile of using GLP-1RAs versus insulin. Conclusions Using GLP-1RAs versus insulin for type 2 diabetes patients requiring intensified injection therapy in clinical practice is cost-effective.

scholarly journals Cost-Effectiveness of SGLT2is Versus DPP4is Among Type 2 Diabetes Patients with and Without Established Cardiovascular Disease: A Model-Based Simulation Analysis Using 10-Year Real-World Data and Systematic Review

2021 ◽  
Author(s):  
Zi-Yang Peng ◽  
Chun-Ting Yang ◽  
Huang-Tz Ou ◽  
Shihchen Kuo
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Real World ◽  
Cost Effective ◽  
Real World Data ◽  
World Data

Abstract Background: We conducted a model-based economic analysis of sodium-glucose cotransporter-2 inhibitors (SGLT2is) versus dipeptidyl peptidase-4 inhibitors (DPP4is) in type 2 diabetes (T2D) patients with and without established cardiovascular disease (CVD) using 10-year real-world data. Methods: A Markov model was utilized to estimate healthcare costs and quality-adjusted life-years (QALYs) over a 10-year simulation time horizon from a healthcare sector perspective, with both costs and QALYs discounted at 3% annually. Model inputs were derived from analyses of Taiwan’s National Health Insurance Research Database or published studies of Taiwanese populations. The primary outcome measure was the incremental cost-effectiveness ratios (ICERs). Incorporated with our study findings, a structured systematic review was conducted to synthesize updated evidence on the cost-effectiveness of SGLT2is versus DPP4is. Results: Over 10 years, use of SGLT2is versus DPP4is yielded ICERs of $3,244 and $4,186 per QALY gained for T2D patients with and without established CVD, respectively. Results were robust across a series of sensitivity and scenario analyses, showing ICERs between $-1,074 (cost-saving) and $8,467 per QALY gained for T2D patients with established CVD and between $369 and $37,122 per QALY gained for T2D patients without established CVD. A systematic review revealed a cost-effective or even cost-saving profile of using SGLT2is for T2D treatment. Conclusions: Use of SGLT2is versus DPP4is was highly cost-effective for T2D patients regardless of patients’ CVD history in real-world clinical practice. Our results extend current evidence by demonstrating SGLT2is as an economically rational alternative over DPP4is for T2D treatment in routine care. Future research is warranted to explore heterogenous economic benefits of SGLT2is given diverse patient characteristics in clinical settings.

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

2020 ◽  
Author(s):  
Ping Zhang ◽  
Karen M. Atkinson ◽  
George Bray ◽  
Haiying Chen ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Health Utility Index ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Utility ◽  
Health Care Expenditures ◽  
Quality Adjusted Life Year

<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>

scholarly journals Measles CEA

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S64-S65
Author(s):  
Emily Hyle
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Economic Value ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
International Travel ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Cost Effectiveness Ratio ◽  
The Impact

Abstract Background Most measles importations are due to returning US travelers infected during international travel. We projected clinical outcomes and assessed cost-effectiveness of pretravel evaluation for measles immunity and MMR vaccination among eligible adult US international travelers. Methods We designed a decision tree to investigate pretravel evaluation compared with no evaluation from the societal perspective. Data from the Global TravEpiNet Consortium and published literature informed input parameters (Figure 1). Outcomes included measles cases averted per 10 million travelers, costs, and the incremental cost-effectiveness ratio (ICER, Δcosts/Δmeasles cases averted); we considered ICERs &lt; $100,000/measles case averted to be cost-effective. We performed sensitivity analyses to assess the impact of varying the probability of exposure based on travel destination, and the percentage of travelers with pre-existing measles immunity. Results In the base case, departure after pretravel evaluation resulted in 16 measles importations and 46 transmissions per 10 million travelers and cost $132 million, vs without pretravel evaluation (26 importations and 87 transmissions per 10 million travelers, costing $22 million). Pretravel evaluation averted 51 measles cases per 10 million travelers with an ICER of $2.2 million per case averted. Results were most sensitive to the probability of measles exposure and the traveler’s pre-existing immunity (Figure 2). Pretravel evaluation was cost-effective for travelers to Asia if pre-existing measles immunity was &lt;80%. Evaluation was always cost-effective for travelers to Africa when pre-existing immunity was less than 100% and became cost saving when the percentage of immune travelers was lower (&lt;70%). Travelers who were more likely to be non-immune and were visiting destinations with higher probabilities of exposure were most likely to benefit from pretravel evaluation for measles immunity at excellent economic value. Conclusion As risk of measles exposure increases and likelihood of travelers’ pre-existing immunity decreases, it can be cost-effective or cost saving to assess US international travelers’ measles immunity status and vaccinate with MMR prior to departure. Disclosures All authors: No reported disclosures.

COST-EFFECTIVENESS OF EXERCISE PROGRAMS IN TYPE 2 DIABETES

2012 ◽  
Vol 28 (3) ◽  
pp. 228-234 ◽  
Author(s):  
Doug Coyle ◽  
Kathryn Coyle ◽  
Glen P. Kenny ◽  
Normand G. Boulé ◽  
George A. Wells ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Exercise Training ◽  
Exercise Program ◽  
Cost Effective ◽  
Exercise Programs ◽  
Combined Exercise ◽  
Use Of Resources ◽  
Life Years

Background: A randomized controlled trial has shown that supervised, facility-based exercise training is effective in improving glycemic control in type 2 diabetes. However, these programs are associated with additional costs. This analysis assessed the cost-effectiveness of such programs.Methods: Analysis used data from the Diabetes Aerobic and Resistance Exercise (DARE) clinical trial which compared three different exercise programs (resistance, aerobic or a combination of both) of 6 months duration with a control group (no exercise program). Clinical outcomes at 6 months were entered for individual patients into the UKPDS economic model for type 2 diabetes adapted for the Canadian context. From this, expected life-years, quality-adjusted life-years (QALYs) and costs were estimated for all patients within the trial.Results: The combined exercise program was the most expensive ($40,050) followed by the aerobic program ($39,250), the resistance program ($38,300) and no program ($31,075). QALYs were highest for combined (8.94), followed by aerobic (8.77), resistance (8.73) and no program (8.70). The incremental cost per QALY gained for the combined exercise program was $4,792 compared with aerobic alone, $8,570 compared with resistance alone, and $37,872 compared with no program. The combined exercise program remained cost-effective for all scenarios considered within sensitivity analysis.Conclusions: A program providing training in both resistance and aerobic exercise was the most cost-effective of the alternatives compared. Based on previous funding decisions, exercise training for individuals with diabetes can be considered an efficient use of resources.

scholarly journals The cost-effectiveness of testing strategies for type 2 diabetes: a modelling study

2015 ◽  
Vol 19 (33) ◽  
pp. 1-80 ◽  
Author(s):  
Mike Gillett ◽  
Alan Brennan ◽  
Penny Watson ◽  
Kamlesh Khunti ◽  
Melanie Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
High Risk ◽  
Risk Score ◽  
Cost Effective ◽  
Data Set ◽  
Uptake Rates ◽  
Multiethnic Population ◽  
The Cost

BackgroundAn estimated 850,000 people have diabetes without knowing it and as many as 7 million more are at high risk of developing it. Within the NHS Health Checks programme, blood glucose testing can be undertaken using a fasting plasma glucose (FPG) or a glycated haemoglobin (HbA1c) test but the relative cost-effectiveness of these is unknown.ObjectivesTo estimate and compare the cost-effectiveness of screening for type 2 diabetes using a HbA1ctest versus a FPG test. In addition, to compare the use of a random capillary glucose (RCG) test versus a non-invasive risk score to prioritise individuals who should undertake a HbA1cor FPG test.DesignCost-effectiveness analysis using the Sheffield Type 2 Diabetes Model to model lifetime incidence of complications, costs and health benefits of screening.SettingEngland; population in the 40–74-years age range eligible for a NHS health check.Data sourcesThe Leicester Ethnic Atherosclerosis and Diabetes Risk (LEADER) data set was used to analyse prevalence and screening outcomes for a multiethnic population. Alternative prevalence rates were obtained from the literature or through personal communication.Methods(1) Modelling of screening pathways to determine the cost per case detected followed by long-term modelling of glucose progression and complications associated with hyperglycaemia; and (2) calculation of the costs and health-related quality of life arising from complications and calculation of overall cost per quality-adjusted life-year (QALY), net monetary benefit and the likelihood of cost-effectiveness.ResultsBased on the LEADER data set from a multiethnic population, the results indicate that screening using a HbA1ctest is more cost-effective than using a FPG. For National Institute for Health and Care Excellence (NICE)-recommended screening strategies, HbA1cleads to a cost saving of £12 and a QALY gain of 0.0220 per person when a risk score is used as a prescreen. With no prescreen, the cost saving is £30 with a QALY gain of 0.0224. Probabilistic sensitivity analysis indicates that the likelihood of HbA1cbeing more cost-effective than FPG is 98% and 95% with and without a risk score, respectively. One-way sensitivity analyses indicate that the results based on prevalence in the LEADER data set are insensitive to a variety of alternative assumptions. However, where a region of the country has a very different joint HbA1cand FPG distribution from the LEADER data set such that a FPG test yields a much higher prevalence of high-risk cases relative to HbA1c, FPG may be more cost-effective. The degree to which the FPG-based prevalence would have to be higher depends very much on the uncertain relative uptake rates of the two tests. Using a risk score such as the Leicester Practice Database Score (LPDS) appears to be more cost-effective than using a RCG test to identify individuals with the highest risk of diabetes who should undergo blood testing.LimitationsWe did not include rescreening because there was an absence of required relevant evidence.ConclusionsBased on the multiethnic LEADER population, among individuals currently attending NHS Health Checks, it is more cost-effective to screen for diabetes using a HbA1ctest than using a FPG test. However, in some localities, the prevalence of diabetes and high risk of diabetes may be higher for FPG relative to HbA1cthan in the LEADER cohort. In such cases, whether or not it still holds that HbA1cis likely to be more cost-effective than FPG depends on the relative uptake rates for HbA1cand FPG. Use of the LPDS appears to be more cost-effective than a RCG test for prescreening.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Daily Almond Consumption in Cardiovascular Disease Prevention via LDL-C Change in the U.S. Population: a Cost-Effectiveness Analysis

2019 ◽  
Author(s):  
Jifan Wang(New Corresponding Author) ◽  
Michelle A. Lee Bravatti ◽  
Elizabeth J. Johnson ◽  
Gowri Raman(Former Corresponding Author)
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Cost Effective ◽  
Dietary Factors ◽  
Sensitivity Analyses ◽  
Healthcare Sector ◽  
Cvd Prevention ◽  
The Cost ◽  
The U.S

Abstract Objectives Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 ounces (42.5 grams) of nut intake may reduce the risk of cardiovascular disease (CVD). Previous studies have focused on the cost-effectiveness of other foods or dietary factors on primary CVD prevention, yet not in almond consumption. This study aimed to examine the cost-effectiveness of almond consumption in CVD primary prevention. Perspective & Setting This study assessed the cost-effectiveness of consuming 42.5 grams of almond from the U.S. healthcare sector perspective. Methods A decision model was developed for 42.5 grams of almond per day versus no almond consumption and CVD in the U.S. population. Parameters in the model were derived from the literature, which included the probabilities of increasing LDL-C, developing acute myocardial infarction (MI) and stroke, treating MI, dying from the disease and surgery, as well as the costs of the disease and procedures in the U.S. population, and the quality-adjusted life years (QALY). The cost of almonds was based on the current price in the U.S. market. Sensitivity analyses were conducted for different levels of willingness-to-pay, the probabilistic sensitivity analysis, ten-year risk prevention, different costs of procedures and almond prices, and patients with or without CVD. Results The almond strategy had $363 lower cost and 0.02 higher QALY gain compared to the non-almond strategy in the base-case model. The annual net monetary benefit (NMB) of almond consumption was $1,421 higher per person than no almond consumption, when the willingness to pay threshold was set at $50,000 for annual health care expenditure. Almond was more cost-effective than non-almond in CVD prevention in all the sensitivity analyses. Conclusion Consuming 42.5 grams of almonds per day is a cost-effective approach to prevent CVD in the short term and potentially in the long term.

scholarly journals Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261231
Author(s):  
Phung Lam Toi ◽  
Olivia Wu ◽  
Montarat Thavorncharoensap ◽  
Varalak Srinonprasert ◽  
Thunyarat Anothaisintawee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Value For Money ◽  
Healthcare Settings ◽  
Annual Screening

Introduction Few economic evaluations have assessed the cost-effectiveness of screening type-2 diabetes mellitus (T2DM) in different healthcare settings. This study aims to evaluate the value for money of various T2DM screening strategies in Vietnam. Methods A decision analytical model was constructed to compare costs and quality-adjusted life years (QALYs) of T2DM screening in different health care settings, including (1) screening at commune health station (CHS) and (2) screening at district health center (DHC), with no screening as the current practice. We further explored the costs and QALYs of different initial screening ages and different screening intervals. Cost and utility data were obtained by primary data collection in Vietnam. Incremental cost-effectiveness ratios were calculated from societal and payer perspectives, while uncertainty analysis was performed to explore parameter uncertainties. Results Annual T2DM screening at either CHS or DHC was cost-effective in Vietnam, from both societal and payer perspectives. Annual screening at CHS was found as the best screening strategy in terms of value for money. From a societal perspective, annual screening at CHS from initial age of 40 years was associated with 0.40 QALYs gained while saving US$ 186.21. Meanwhile, one-off screening was not cost-effective when screening for people younger than 35 years old at both CHS and DHC. Conclusions T2DM screening should be included in the Vietnamese health benefits package, and annual screening at either CHS or DHC is recommended.

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