Healthcare costs associated with gestational diabetes in pregnancy and potential cost- effectiveness of prevention in high-risk women Obesity Research and Clinical Practice

Catherine L Keating, Cheryce Lee Harrison, Catherine B Lombard, Jacqueline Boyle, Marjory L Moodie, Helena Jane Teede

Research output: Contribution to journalLetterOther

Abstract

Background: Gestational Diabetes Mellitus (GDM) affects 14 of pregnancies in Australia and is associated with an increased risk of pregnancy complications and developing type 2 diabetes. Methods: A modelled micro-costing study to estimate the excess healthcare utilisation and costs associated to GDM was undertaken. Clinical guidelines and expert opinion of endocrinologists and obstetricians were utilised to describe the clinical pathway associated to GDM surveillance and management during pregnancy. National epidemiological data was utilised to estimate GDM-attributable complication rates. National cost weights were attached to all healthcare resources. Estimated GDM healthcare costs were used to inform a cost-effectiveness analysis of GDM prevention. Data were sourced from a recent Australian RCT in 228 women at increased GDM risk which found that a behavioural lifestyle intervention significantly reduced excess gestational weight gain and a trend for lower GDM incidence in the intervention group. Results: Healthcare costs attributable to GDM were estimated to be ?AUD3200 per patient during pregnancy and the early neonatal period. One third of these costs related to GDM surveillance and management which are relatively fixed costs contingent upon a GDM diagnosis and designation of a pregnancy as high-risk. The remaining costs related to obstetric and neonatal complications attributable to GDM. GDM prevention cost-effectiveness results are forthcoming. Conclusions: The GDM cost estimated in this study can be utilised to inform GDM economic evaluations. Our study suggests that, from a financial perspective, spending AUD3200 to prevent one case of GDM would be cost-neutral based on pregnancy and neonatal costs. For GDM prevention, existing engagement in antenatal care provides an opportunity to target high-risk women. Furthermore, pregnancy is a time of significant motivation for women around healthy behaviours. These attributes of the antenatal setting, combined with increasing evidence that GDM is preventable, make economic evaluation of GDM interventions a priority.
Original languageEnglish
Pages (from-to)e58 - e58
Number of pages1
JournalObesity Research and Clinical Practice
Volume7
Issue number2
Publication statusPublished - 2013

Cite this

@article{223fe67f204649f9a98dcd47853b81fe,
title = "Healthcare costs associated with gestational diabetes in pregnancy and potential cost- effectiveness of prevention in high-risk women Obesity Research and Clinical Practice",
abstract = "Background: Gestational Diabetes Mellitus (GDM) affects 14 of pregnancies in Australia and is associated with an increased risk of pregnancy complications and developing type 2 diabetes. Methods: A modelled micro-costing study to estimate the excess healthcare utilisation and costs associated to GDM was undertaken. Clinical guidelines and expert opinion of endocrinologists and obstetricians were utilised to describe the clinical pathway associated to GDM surveillance and management during pregnancy. National epidemiological data was utilised to estimate GDM-attributable complication rates. National cost weights were attached to all healthcare resources. Estimated GDM healthcare costs were used to inform a cost-effectiveness analysis of GDM prevention. Data were sourced from a recent Australian RCT in 228 women at increased GDM risk which found that a behavioural lifestyle intervention significantly reduced excess gestational weight gain and a trend for lower GDM incidence in the intervention group. Results: Healthcare costs attributable to GDM were estimated to be ?AUD3200 per patient during pregnancy and the early neonatal period. One third of these costs related to GDM surveillance and management which are relatively fixed costs contingent upon a GDM diagnosis and designation of a pregnancy as high-risk. The remaining costs related to obstetric and neonatal complications attributable to GDM. GDM prevention cost-effectiveness results are forthcoming. Conclusions: The GDM cost estimated in this study can be utilised to inform GDM economic evaluations. Our study suggests that, from a financial perspective, spending AUD3200 to prevent one case of GDM would be cost-neutral based on pregnancy and neonatal costs. For GDM prevention, existing engagement in antenatal care provides an opportunity to target high-risk women. Furthermore, pregnancy is a time of significant motivation for women around healthy behaviours. These attributes of the antenatal setting, combined with increasing evidence that GDM is preventable, make economic evaluation of GDM interventions a priority.",
author = "Keating, {Catherine L} and Harrison, {Cheryce Lee} and Lombard, {Catherine B} and Jacqueline Boyle and Moodie, {Marjory L} and Teede, {Helena Jane}",
year = "2013",
language = "English",
volume = "7",
pages = "e58 -- e58",
journal = "Obesity Research and Clinical Practice",
issn = "1871-403X",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Healthcare costs associated with gestational diabetes in pregnancy and potential cost- effectiveness of prevention in high-risk women Obesity Research and Clinical Practice

AU - Keating, Catherine L

AU - Harrison, Cheryce Lee

AU - Lombard, Catherine B

AU - Boyle, Jacqueline

AU - Moodie, Marjory L

AU - Teede, Helena Jane

PY - 2013

Y1 - 2013

N2 - Background: Gestational Diabetes Mellitus (GDM) affects 14 of pregnancies in Australia and is associated with an increased risk of pregnancy complications and developing type 2 diabetes. Methods: A modelled micro-costing study to estimate the excess healthcare utilisation and costs associated to GDM was undertaken. Clinical guidelines and expert opinion of endocrinologists and obstetricians were utilised to describe the clinical pathway associated to GDM surveillance and management during pregnancy. National epidemiological data was utilised to estimate GDM-attributable complication rates. National cost weights were attached to all healthcare resources. Estimated GDM healthcare costs were used to inform a cost-effectiveness analysis of GDM prevention. Data were sourced from a recent Australian RCT in 228 women at increased GDM risk which found that a behavioural lifestyle intervention significantly reduced excess gestational weight gain and a trend for lower GDM incidence in the intervention group. Results: Healthcare costs attributable to GDM were estimated to be ?AUD3200 per patient during pregnancy and the early neonatal period. One third of these costs related to GDM surveillance and management which are relatively fixed costs contingent upon a GDM diagnosis and designation of a pregnancy as high-risk. The remaining costs related to obstetric and neonatal complications attributable to GDM. GDM prevention cost-effectiveness results are forthcoming. Conclusions: The GDM cost estimated in this study can be utilised to inform GDM economic evaluations. Our study suggests that, from a financial perspective, spending AUD3200 to prevent one case of GDM would be cost-neutral based on pregnancy and neonatal costs. For GDM prevention, existing engagement in antenatal care provides an opportunity to target high-risk women. Furthermore, pregnancy is a time of significant motivation for women around healthy behaviours. These attributes of the antenatal setting, combined with increasing evidence that GDM is preventable, make economic evaluation of GDM interventions a priority.

AB - Background: Gestational Diabetes Mellitus (GDM) affects 14 of pregnancies in Australia and is associated with an increased risk of pregnancy complications and developing type 2 diabetes. Methods: A modelled micro-costing study to estimate the excess healthcare utilisation and costs associated to GDM was undertaken. Clinical guidelines and expert opinion of endocrinologists and obstetricians were utilised to describe the clinical pathway associated to GDM surveillance and management during pregnancy. National epidemiological data was utilised to estimate GDM-attributable complication rates. National cost weights were attached to all healthcare resources. Estimated GDM healthcare costs were used to inform a cost-effectiveness analysis of GDM prevention. Data were sourced from a recent Australian RCT in 228 women at increased GDM risk which found that a behavioural lifestyle intervention significantly reduced excess gestational weight gain and a trend for lower GDM incidence in the intervention group. Results: Healthcare costs attributable to GDM were estimated to be ?AUD3200 per patient during pregnancy and the early neonatal period. One third of these costs related to GDM surveillance and management which are relatively fixed costs contingent upon a GDM diagnosis and designation of a pregnancy as high-risk. The remaining costs related to obstetric and neonatal complications attributable to GDM. GDM prevention cost-effectiveness results are forthcoming. Conclusions: The GDM cost estimated in this study can be utilised to inform GDM economic evaluations. Our study suggests that, from a financial perspective, spending AUD3200 to prevent one case of GDM would be cost-neutral based on pregnancy and neonatal costs. For GDM prevention, existing engagement in antenatal care provides an opportunity to target high-risk women. Furthermore, pregnancy is a time of significant motivation for women around healthy behaviours. These attributes of the antenatal setting, combined with increasing evidence that GDM is preventable, make economic evaluation of GDM interventions a priority.

UR - http://www.sciencedirect.com.ezproxy.lib.monash.edu.au/science/article/pii/S1871403X14003603

M3 - Letter

VL - 7

SP - e58 - e58

JO - Obesity Research and Clinical Practice

JF - Obesity Research and Clinical Practice

SN - 1871-403X

IS - 2

ER -