The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: Application of a new model in India and Israel

Elliot Marseille*, Nicolai Lohse, Aliya Jiwani, Moshe Hod, Veeraswamy Seshiah, Chittaranjan S. Yajnik, Geeti Puri Arora, Vijayam Balaji, Ole Henriksen, Nicky Lieberman, Rony Chen, Peter Damm, Boyd E. Metzger, James G. Kahn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objective: Gestational diabetes mellitus (GDM) is associated with elevated risks of perinatal complications and type 2 diabetes mellitus, and screening and intervention can reduce these risks. We quantified the cost, health impact and cost-effectiveness of GDM screening and intervention in India and Israel, settings with contrasting epidemiologic and cost environments. Methods: We developed a decision-analysis tool (the GeDiForCE™) to assess cost-effectiveness. Using both local data and published estimates, we applied the model for a general medical facility in Chennai, India and for the largest HMO in Israel. We computed costs (discounted international dollars), averted disability-adjusted life years (DALYs) and net cost per DALY averted, compared with no GDM screening. Results: The programme costs per 1000 pregnant women are $259139 in India and $259929 in Israel. Net costs, adjusted for averted disease, are $194358 and $76102, respectively. The cost per DALY averted is $1626 in India and $1830 in Israel. Sensitivity analysis findings range from $628 to $3681 per DALY averted in India and net savings of $72420-8432 per DALY averted in Israel. Conclusion: GDM interventions are highly cost-effective in both Indian and Israeli settings, by World Health Organization standards. Noting large differences between these countries in GDM prevalence and costs, GDM intervention may be cost-effective in diverse settings.

Original languageEnglish (US)
Pages (from-to)802-810
Number of pages9
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume26
Issue number8
DOIs
StatePublished - May 2013

Keywords

  • Cost-effectiveness analysis
  • Costs
  • Diagnosis
  • Gestational diabetes mellitus
  • Management
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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