@article{3e699b2748154aaa99ae59758141ba20,
title = "Economic evaluation of a mobile phone text-message intervention for Australian adults with type 2 diabetes",
abstract = "Background: The rising prevalence of type 2 diabetes in Australia is a public health concern, contributing to significant disease burden and economic costs. Text-message programs have been shown to improve health outcomes for people with type 2 diabetes, however they remain underutilized, and no evidence exists on their cost-effectiveness or costs of scale up to a population level in Australia. This study aimed to determine the cost-effectiveness and cost-utility of a 6-month text-message intervention (DTEXT) to improve glycated hemoglobin (HbA1c) and self-management behaviors for Australian adults with type 2 diabetes. Methods: A within-trial economic evaluation was conducted on the DTEXT randomized controlled trial. Incremental cost-effectiveness ratios (ICERs) were determined per 11 mmol/mol (1%) reduced HbA1c and per quality adjusted life year (QALY) gained, compared to usual care. Cost-effectiveness acceptability curves (CEAC) determined the probability of the intervention being cost-effective over a range of willingness to pay thresholds. A scenario analysis was conducted to determine how cost-effectiveness was impacted by using current implementation costs. Results: The DTEXT intervention cost AU$36 (INT$24) per participant, with an ICER of AU$311 (INT$211) per 11 mmol/mol (1%) reduced HbA1c. Based on HbA1c outcomes, DTEXT had a 33% probability of being effective and cost-saving. Based on the QALY outcomes, the intervention had only a 24% probability of being cost-effective. Scenario analysis indicated costs per participant of AU$13 (INT$9) to deliver the intervention, with a reduced incremental cost effectiveness ratio of AU$151 (INT$103) per 11 mmol/mol (1%) reduced HbA1c and a 38% probability of being effective and cost-saving. Conclusions: DTEXT was low cost and potentially scalable, but only had a low to moderate probability of being effective and cost saving. Further research should determine more targeted approaches that may improve cost-effectiveness.",
keywords = "cost-effectiveness, diabetes, Economic evaluation, self-management, text-messages",
author = "Waller, {Karen A.} and Killedar, {Anagha A.} and Furber, {Susan E.} and Tan, {Eng Joo} and Gibson, {Alice A.} and Bauman, {Adrian E.} and Hayes, {Alison J.}",
note = "Funding Information: We would like to thank the DTEXT Advisory Committee{\textquoteright}s for their guidance in the study design; and Vanessa Jackson, Dr. Jenny Norman and Tania Starr from the Illawarra Shoalhaven Local Health District Health Promotion Service for their administrative support and advice. Funding: This work was supported by a NSW Ministry of Health Translational Research Grants Scheme (Round 1: 2016, Project ID: 23). The funding source had no involvement in the study design; collection, analysis or interpretation of data; writing of the report; or decision to submit the article for publication. Funding Information: Reporting Checklist: The authors have completed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting checklist. Available at https://mhealth.amegroups.com/article/view/10.21037/ mhealth-22-26/rc Data Sharing Statement: Available at https://mhealth. amegroups.com/article/view/10.21037/mhealth-22-26/dss Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://mhealth. amegroups.com/article/view/10.21037/mhealth-22-26/ coif). AAG received salary support through an Emerging Leader 1 Investigator Grant (No. AAP1173784) from the Australian National Health and Medical Research Council and chose to spend her work time on this study. All other authors report that this work was supported by a NSW Ministry of Health Translational Research Grants Scheme (Round 1: 2016, Project ID: 23). AAK is supported by an Australian National Health and Medical Research Council Postgraduate research stipend (No. APP1169039) and salary funding (No. APP1101675) for research projects unrelated to this project. The authors have no other conflicts of interest to declare. Publisher Copyright: {\textcopyright} 2022 National Academy of Kinesiology.",
year = "2023",
month = apr,
doi = "10.21037/MHEALTH-22-26",
language = "English",
volume = "9",
journal = "mHealth",
issn = "2306-9740",
publisher = "AME Publishing Company",
}
