Cost-utility analysis of lifestyle modification program for Thai patients with metabolic syndrome

Abstract

Background : Several foreign trials indicated clinical benefits and cost-effectiveness of the lifestyle programs for patients with metabolic syndrome (MetS) but the economic benefit of such programs has not yet been evaluated in Thailand.

Objective :  This study was aimed to assess the cost-effectiveness of the lifestyle modification program for Thai MetS patients compared with the usual care.

Design : Secondary data analysis with modelling design.

Setting : Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University

Methods : A cost-utility analysis was performed based on Praphasil and colleagues’ study of 90 MetS patients randomly allocated to the lifestyle modification program and control groups. A Markov micro-simulation model with the Differences-in-Differences method was used to predict the lifetime costs from societal perspective and quality-adjusted life years (QALYs) from patients’ metabolic parameters. The 3% discount rate per annum was employed to discount the costs and outcomes. Parameter uncertainties were identified using a sensitivity analysis.

Results : The lifetime costs calculated from patients’ metabolic parameters tended to decrease from week 0 to week 12 in both groups. The decrease in the costs of intervention group was more than that of control group. Hence, the program could save the lifetime costs 2,280 baht and gain 0.0098 QALYs, compared with the usual care. From the sensitivity analysis, probability of cost-effectiveness of the program was up to 99.6% as determined by the Thai willingness to pay threshold.

Conclusion : The lifestyle modification program for MetS patients implemented in the Thai settings provide lower lifetime cost and higher outcome or QALY.