Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK

Diabet Med. 2017 Aug;34(8):1136-1144. doi: 10.1111/dme.13349. Epub 2017 Apr 18.


Aim: To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework.

Methods: A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person.

Results: All interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs.

Conclusion: The model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.

MeSH terms

  • Carbonated Beverages / adverse effects
  • Carbonated Beverages / economics
  • Computer Simulation
  • Cost Savings
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet, Healthy* / economics
  • England
  • Health Education / economics
  • Health Policy*
  • Health Promotion / economics*
  • Health Surveys
  • Healthy Lifestyle*
  • Humans
  • Mass Screening / economics
  • Models, Economic*
  • Quality of Life*
  • Residence Characteristics
  • Taxes
  • Workplace