Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes

Weiqin Li; Cuiping Zhang; Junhong Leng; Ping Shao; Huiguang Tian; Fuxia Zhang; Ling Dong; Zhijie Yu; Juliana C.N. Chan; Gang Hu; Ping Zhang; Xilin Yang

doi:10.1371/journal.pone.0237738

Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes

Weiqin Li, Cuiping Zhang, Junhong Leng, Ping Shao, Huiguang Tian, Fuxia Zhang, Ling Dong, Zhijie Yu, Juliana C.N. Chan, Gang Hu, Ping Zhang, Xilin Yang

Medicine

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

This study assessed within-trial cost-effectiveness of a shared care program (SC, n = 339) for pregnancy outcomes compared to usual care (UC, n = 361), as implemented in a randomized trial of Chinese women with gestational diabetes (GDM). SC consisted of an individualized dietary advice and physical activity counseling program. The UC was a one-time group education program. The effectiveness was measured by number needed to treat (NNT) to prevent one macrosomia/large for gestational age (LGA) infant. The cost-effectiveness was measured by incremental cost-effectiveness ratio in terms of cost (2012 Chinese Yuan/US dollar) per case of macrosomia and LGA prevented. The study took both a health care system and a societal perspective. This study found that the NNT was 16/14 for macrosomia/ LGA. The incremental cost for treating a pregnant woman was ¥1,877 ($298) from a health care system perspective and ¥2,056 ($327) from a societal perspective. The cost of preventing a case of macrosomia/LGA from the two corresponding perspectives were ¥30,032/¥26,278 ($4,775/$4,178) and ¥32,896/¥28,784 ($5,230/$4,577), respectively. Considering the potential severe adverse health and economic consequences of a macrosomia/ LGA infant, our findings suggest that implementing this lifestyle intervention for women with GDM is an efficient use of health care resources.

Original language	English
Article number	e0237738
Journal	PLoS One
Volume	15
Issue number	8 August
DOIs	https://doi.org/10.1371/journal.pone.0237738
Publication status	Published - Aug 2020

Bibliographical note

Funding Information:
This project was supported by the National Key Research and Development Program of China (Grants No: 2018YFC1313900, 2018YFC1313903, 2016YFC1300101 and 2016YFC0900602), and BRIDGES (Project No: LT09-227). BRIDGES is an International Diabetes Federation program supported by an educational grant from Lilly Diabetes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to express special thanks to the obstetricians and other health professionals in the 64 primary care hospitals and 6 district women and children's health care institutions involved in the trial.

Publisher Copyright:
© 2020 Public Library of Science. All rights reserved.

ASJC Scopus Subject Areas

General

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Li, W., Zhang, C., Leng, J., Shao, P., Tian, H., Zhang, F., Dong, L., Yu, Z., Chan, J. C. N., Hu, G., Zhang, P., & Yang, X. (2020). Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes. PLoS One, 15(8 August), Article e0237738. https://doi.org/10.1371/journal.pone.0237738

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abstract = "This study assessed within-trial cost-effectiveness of a shared care program (SC, n = 339) for pregnancy outcomes compared to usual care (UC, n = 361), as implemented in a randomized trial of Chinese women with gestational diabetes (GDM). SC consisted of an individualized dietary advice and physical activity counseling program. The UC was a one-time group education program. The effectiveness was measured by number needed to treat (NNT) to prevent one macrosomia/large for gestational age (LGA) infant. The cost-effectiveness was measured by incremental cost-effectiveness ratio in terms of cost (2012 Chinese Yuan/US dollar) per case of macrosomia and LGA prevented. The study took both a health care system and a societal perspective. This study found that the NNT was 16/14 for macrosomia/ LGA. The incremental cost for treating a pregnant woman was ¥1,877 ($298) from a health care system perspective and ¥2,056 ($327) from a societal perspective. The cost of preventing a case of macrosomia/LGA from the two corresponding perspectives were ¥30,032/¥26,278 ($4,775/$4,178) and ¥32,896/¥28,784 ($5,230/$4,577), respectively. Considering the potential severe adverse health and economic consequences of a macrosomia/ LGA infant, our findings suggest that implementing this lifestyle intervention for women with GDM is an efficient use of health care resources.",

author = "Weiqin Li and Cuiping Zhang and Junhong Leng and Ping Shao and Huiguang Tian and Fuxia Zhang and Ling Dong and Zhijie Yu and Chan, {Juliana C.N.} and Gang Hu and Ping Zhang and Xilin Yang",

note = "Funding Information: This project was supported by the National Key Research and Development Program of China (Grants No: 2018YFC1313900, 2018YFC1313903, 2016YFC1300101 and 2016YFC0900602), and BRIDGES (Project No: LT09-227). BRIDGES is an International Diabetes Federation program supported by an educational grant from Lilly Diabetes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to express special thanks to the obstetricians and other health professionals in the 64 primary care hospitals and 6 district women and children's health care institutions involved in the trial. Publisher Copyright: {\textcopyright} 2020 Public Library of Science. All rights reserved.",

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AU - Li, Weiqin

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AU - Leng, Junhong

AU - Shao, Ping

AU - Tian, Huiguang

AU - Zhang, Fuxia

AU - Dong, Ling

AU - Yu, Zhijie

AU - Chan, Juliana C.N.

AU - Hu, Gang

AU - Zhang, Ping

AU - Yang, Xilin

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PY - 2020/8

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N2 - This study assessed within-trial cost-effectiveness of a shared care program (SC, n = 339) for pregnancy outcomes compared to usual care (UC, n = 361), as implemented in a randomized trial of Chinese women with gestational diabetes (GDM). SC consisted of an individualized dietary advice and physical activity counseling program. The UC was a one-time group education program. The effectiveness was measured by number needed to treat (NNT) to prevent one macrosomia/large for gestational age (LGA) infant. The cost-effectiveness was measured by incremental cost-effectiveness ratio in terms of cost (2012 Chinese Yuan/US dollar) per case of macrosomia and LGA prevented. The study took both a health care system and a societal perspective. This study found that the NNT was 16/14 for macrosomia/ LGA. The incremental cost for treating a pregnant woman was ¥1,877 ($298) from a health care system perspective and ¥2,056 ($327) from a societal perspective. The cost of preventing a case of macrosomia/LGA from the two corresponding perspectives were ¥30,032/¥26,278 ($4,775/$4,178) and ¥32,896/¥28,784 ($5,230/$4,577), respectively. Considering the potential severe adverse health and economic consequences of a macrosomia/ LGA infant, our findings suggest that implementing this lifestyle intervention for women with GDM is an efficient use of health care resources.

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Within-trial cost-effectiveness of lifestyle intervention using a 3-tier shared care approach for pregnancy outcomes in Chinese women with gestational diabetes

Abstract

Bibliographical note

ASJC Scopus Subject Areas

UN SDGs

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