Cost-Effectiveness Analysis of the Self-Management Program for Thai Patients with Metabolic Syndrome
อาณัติ สกุลทรัพย์ศิริ, พรรณทิพา ศักดิ์ทอง*, Win Winit-Watjana
Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand

Background: Lifestyle modification programs are partly evaluated for their usefulness.

Objectives: This study aimed to assess the cost-effectiveness and healthy lifestyle persistence of a self-management program (SMP) for patients with metabolic syndrome (MetS) in Thai health care settings.

Methods: A cost-effectiveness analysis was performed on the basis of an intervention study of 90 patients with MetS randomly allocated to the SMP and control groups. A Markov model with the Difference-in-Difference method was used to predict the lifetime costs from a societal perspective and quality-adjusted life-years (QALYs), of which 95% confidence intervals (CIs) were estimated by bootstrapping. The cost-effectiveness analysis, along with healthy lifestyle persistence, was performed using the discount rate of 3% per annum. Parameter uncertainties were identified using one-way and probabilistic sensitivity analyses.

Results: The lifetime costs tended to decrease in both groups. The SMP could save lifetime costs (−2310 baht; 95% CI −5960 to 1400) and gain QALYs (0.0098; 95% CI −0.0003 to 0.0190), compared with ordinary care. The probability of cost-effectiveness was 99.4% from the Monte-Carlo simulation, and the program was deemed cost-effective at dropout rates below 69% per year as determined by the threshold of 160,000 baht per QALY gained. The cost of macrovascular complications was the most influencing variable for the overall incremental cost-effectiveness ratio.

Conclusions: The SMP provided by the health care settings is marginally cost-effective, and the persistence results support the implementation of the program to minimize the complications and economic burden of patients with MetS.

Value in Health Regional Issues ปี 2560, May ปีที่: 9 ฉบับที่ หน้า 28-35
Thailand, Cost-effectiveness analysis, Self-management Program, Metabolic syndrome