Cost-effectiveness analysis of the Neuropad device as a screening tool for early diabetic peripheral neuropathy

Eur J Health Econ. 2020 Apr;21(3):335-349. doi: 10.1007/s10198-019-01134-2. Epub 2019 Nov 12.


Objective: To carry out a cost-effectiveness analysis of the use of Neuropad as a screening test for diabetic neuropathy together with the standard care tool, the 10-g monofilament, in people with diabetes.

Research design and methods: A cost-effectiveness analysis using a Markov model was developed to assess the impact on costs and outcomes of using Neuropad as a test for diabetic neuropathy (1) as a complement to the standard test, the 10-g monofilament (Neuropad + monofilament vs. monofilament); and (2) as a substitute for the monofilament (Neuropad vs. monofilament); from the healthcare provider perspective. The time horizon was 3 years. Data on costs and health gains were extracted from the literature. The incremental cost-utility ratio was calculated. Deterministic and probabilistic sensitivity analyses were also performed.

Results: Compared with standard care, Neuropad, in combination with the 10-g monofilament tool, is the dominant strategy as it leads to higher health gains and lower costs. In practice, compared with using the monofilament alone, performing both tests would lead to a savings of £1049.26 per patient and 0.044 QALY gain. Results were found to be consistent across the sensitivity analyses.

Conclusions: Using both screening tools (Neuropad + monofilament) is a cost-effective strategy and the dominant alternative, when compared against using the 10-g monofilament alone. The results would be of special relevance in the early detection of diabetic peripheral neuropathy and to ensure the efficient allocation of resources and, thus, the sustainability of healthcare systems.

Keywords: Cost-effectiveness; Diabetes; Diabetic peripheral neuropathy; Neuropad; SWME.

Publication types

  • Comparative Study

MeSH terms

  • Cost-Benefit Analysis
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / economics
  • Diagnostic Techniques, Neurological*
  • Early Diagnosis*
  • Markov Chains
  • Peripheral Nervous System Diseases / diagnosis*
  • Quality-Adjusted Life Years
  • Sensitivity and Specificity