Type 2 diabetes is a highly prevalent chronic disease progression to simulate the lifetime diabetes-related costs and quality-adjusted with diabetes. …
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Screening for Type 2 Diabetes Mellitus: A Cost-Effectiveness Analysis
Hoerger, TJ, Harris, R, Hicks, KA, Donahue, K, Sorensen, S, et al 2004 Screening for type 2 diabetes mellitus: A cost-effectiveness analysis Annals of Internal Medicine, 140 9:689-699 Type 2 diabetes is a highly prevalent chronic disease causing extensive mortality and morbidity and accounting for a large share of medical expenditures in the US About 93 of US adults approximately 193 million have diabetes; 29 of these cases are undiagnosed Although the prevalence of undiagnosed diabetes is high, it is unclear whether systematic screening for diabetes is likely to be cost-effective Thomas Hoerger Katherine Hicks Systematic screening for diabetes on a population basis is expensive, and it is not clear whether early treatment will slow the progression of the disease No clinical trial of diabetes screening has been conducted To evaluate the cost-effectiveness of screening adults for type 2 diabetes, we applied a Markov model of disease progression to simulate the lifetime diabetes-related costs and quality-adjusted life-years QALYs of persons with diabetes We expanded the model to
incorporate screening costs and compared two strategies: screening targeted to individuals with hypertension and universal screening At all ages, screening targeted to individuals with hypertension was more cost-effective than universal screening At age 55, for example, the costeffectiveness ratio for targeted 
screening compared to no screening was 34,000 per QALY, while the costeffectiveness ratio for universal screening compared to no screening was 361,000 per QALY Cost-effectiveness models are particularly useful in helping policymakers make informed decisions when clinical trials are infeasible or cannot provide useful answers in a timely manner In this case, our analysis supports screening for diabetes among persons known to already have hypertension Screening is beneficial among this population because persons with hypertension and diabetes receive greater benefits from intensive hypertension control than persons who have hypertension but not diabetes Therefore, knowing diabetes status can lead to more appropriate treatment for persons with hypertension Link: http://wwwannalsorg/cgi/content/abstract/140/9/689
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