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 $259,139 in India and $259,929 in Israel. Net costs, adjusted for averted disease, are $194,358 and $76,102, 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 $72,420-8432 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.
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 $259,139 in India and $259,929 in Israel. Net costs, adjusted for averted disease, are $194,358 and $76,102, 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 $72,420-8432 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.
Authors: Jack Milln; Betty Nakabuye; Barnabas Kahiira Natamba; Isaac Sekitoleko; Michael Mubiru; Arthur Araali Namara; Samuel Tumwesigire; Salome Tino; Mandy Mirembe; Ayoub Kakande; Brian Agaba; Faridah Nansubuga; Daniel Zaake; Ben Ayiko; Herbert Kalema; Sarah Nakubulwa; Musa Sekikubo; Annettee Nakimuli; Emily L Webb; Moffat J Nyirenda Journal: BMC Pregnancy Childbirth Date: 2021-05-19 Impact factor: 3.007
Authors: E A Huhn; T Fischer; C S Göbl; M Todesco Bernasconi; M Kreft; M Kunze; A Schoetzau; E Dölzlmüller; W Eppel; P Husslein; N Ochsenbein-Koelble; R Zimmermann; E Bäz; H Prömpeler; E Bruder; S Hahn; I Hoesli Journal: BMJ Open Date: 2016-10-12 Impact factor: 2.692
Authors: Hayfaa Wahabi; Amel Fayed; Safaa M S Tunkar; Hanadi Bakhsh; Ali M Al-Hazmi; Samia Esmaeil; Amna R Siddiqui Journal: PLoS One Date: 2019-01-07 Impact factor: 3.240