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The cost-effectiveness of the Dose Adjustment for Normal Eating (DAFNE) structured education programme: an update using the Sheffield Type 1 Diabetes policy model

Kruger, J., Brennan, A., Thokala, P., Basarir, H., Jacques, R., Elliot, J., Heller, S. and Speight, J. 2013, The cost-effectiveness of the Dose Adjustment for Normal Eating (DAFNE) structured education programme: an update using the Sheffield Type 1 Diabetes policy model, Diabetic medicine, vol. 30, no. 10, pp. 1236-1244, doi: 10.1111/dme.12270.

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Title The cost-effectiveness of the Dose Adjustment for Normal Eating (DAFNE) structured education programme: an update using the Sheffield Type 1 Diabetes policy model
Author(s) Kruger, J.
Brennan, A.
Thokala, P.
Basarir, H.
Jacques, R.
Elliot, J.
Heller, S.
Speight, J.ORCID iD for Speight, J. orcid.org/0000-0002-1204-6896
Journal name Diabetic medicine
Volume number 30
Issue number 10
Start page 1236
End page 1244
Total pages 7
Publisher Wiley-Blackwell Publishing
Place of publication Chichester, England
Publication date 2013-10
ISSN 0742-3071
1464-5491
Keyword(s) flexible intensive insulin therapy
diabetes mellitus
microvascular diabetes-related complications
macrovascular diabetes-related complications
National health service UK
Summary AIMS: 
To estimate the cost-effectiveness of training in flexible intensive insulin therapy [as provided in the Dose Adjustment for Normal Eating (DAFNE) structured education programme] compared with no training for adults with Type 1 diabetes mellitus in the UK using the Sheffield Type 1 Diabetes Policy Model.

METHODS: 
The Sheffield Type 1 Diabetes Policy Model was used to simulate the development of long-term microvascular and macrovascular diabetes-related complications and the occurrence of diabetes-related adverse events in 5000 adults with Type 1 diabetes. Total costs and quality-adjusted life years were estimated from a National Health Service perspective over a lifetime horizon, discounted at a rate of 3.5%. The treatment effectiveness of DAFNE was modelled as a reduction in HbA1c that affected the risk of developing long-term diabetes-related complications. Probabilistic and structural sensitivity analyses were conducted.

RESULTS:
DAFNE resulted in greater life expectancy and reduced incidence of some diabetes-related complications compared with no DAFNE. DAFNE was found to generate an average of 0.0294 additional quality-adjusted life years for an additional cost of £426 per patient, leading to an incremental cost-effectiveness ratio of £14 400 compared with no DAFNE. There was a 54% probability that DAFNE would be cost-effective at a willingness-to-pay threshold of £20 000 per quality-adjusted life year.

CONCLUSIONS: 
The results of this study suggest that DAFNE is a cost-effective structured education programme for people with Type 1 diabetes and support its provision by the National Health Service in the UK.
Language eng
DOI 10.1111/dme.12270
Field of Research 170106 Health, Clinical and Counselling Psychology
111712 Health Promotion
111714 Mental Health
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Wiley-Blackwell Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30056031

Document type: Journal Article
Collection: School of Psychology
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Created: Wed, 18 Sep 2013, 14:27:13 EST by Claudia Gasch

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