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
บทคัดย่อ

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.

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