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Cost-Effectiveness of Lifestyle Counselling as Primary Prevention of Gestational Diabetes Mellitus: Findings from a Cluster-Randomised Trial

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  • Päivi Kolu
  • Jani Raitanen
  • Pekka Rissanen
  • Riitta Luoto

Abstract

Aims: The aim was to evaluate the cost-effectiveness of primary prevention of gestational diabetes mellitus (GDM) through intensified counselling on physical activity, diet, and appropriate weight gain among the risk group. Materials and Methods: The cost-effectiveness analysis was based on data from a cluster-randomised controlled GDM prevention trial carried out in primary health-care maternity clinics in Finland. Women (n = 399) with at least one risk factor for GDM were included. The incremental cost-effectiveness ratio (ICER) was calculated in terms of birth weight, 15D, and perceived health as measured with a visual analogue scale (VAS). A bootstrap technique for cluster-randomised samples was used to estimate uncertainty around a cost-effectiveness acceptability curve. Results: The mean total cost in the intervention group was €7,763 (standard deviation (SD): €4,511) and in the usual-care group was €6,994 (SD: €4,326, p = 0.14). The mean intervention cost was €141. The difference for costs in the birth-weight group was €753 (95% CI: −250 to 1,818) and in effects for birth weight was 115 g (95% CI: 15 to 222). The ICER for birth weight was almost €7, with 86.7% of bootstrap pairs located in the north-east quadrant, indicating that the intervention was more effective and more expensive in birth weight terms than the usual care was. The data show an 86.7% probability that each gram of birth weight avoided requires an additional cost of €7. Conclusions: Intervention was effective for birth weight but was not cost-effective for birth weight, 15D, or VAS when compared to the usual care. Trial Registration: ISRCTN 33885819.

Suggested Citation

  • Päivi Kolu & Jani Raitanen & Pekka Rissanen & Riitta Luoto, 2013. "Cost-Effectiveness of Lifestyle Counselling as Primary Prevention of Gestational Diabetes Mellitus: Findings from a Cluster-Randomised Trial," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-12, February.
    • Handle: RePEc:plo:pone00:0056392
    DOI: 10.1371/journal.pone.0056392
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    References listed on IDEAS

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    1. Manuel Gomes & Edmond S.-W. Ng & Richard Grieve & Richard Nixon & James Carpenter & Simon G. Thompson, 2012. "Developing Appropriate Methods for Cost-Effectiveness Analysis of Cluster Randomized Trials," Medical Decision Making, , vol. 32(2), pages 350-361, March.
    2. Scheffler, R.M. & Feuchtbaum, L.B. & Phibbs, C.S., 1992. "Prevention: The cost-effectiveness of the California Diabetes and Pregnancy Program," American Journal of Public Health, American Public Health Association, vol. 82(2), pages 168-175.
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    1. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.
    2. Elizabeth Parody-Rúa & Maria Rubio-Valera & César Guevara-Cuellar & Ainhoa Gómez-Lumbreras & Marc Casajuana-Closas & Cristina Carbonell-Duacastella & Ignacio Aznar-Lou, 2020. "Economic Evaluations Informed Exclusively by Real World Data: A Systematic Review," IJERPH, MDPI, vol. 17(4), pages 1-18, February.
    3. Corina Zugravu & Andreea Petra & Valeria-Anca Pietroșel & Bianca-Margareta Mihai & Doina-Andrada Mihai & Roxana-Elena Bohîlțea & Monica Tarcea, 2023. "Nutritional Interventions and Lifestyle Changing in Gestational Diabetes Mellitus Prevention: A Narrative Review," Sustainability, MDPI, vol. 15(2), pages 1-23, January.
    4. Päivi Kolu & Jani Raitanen & Jatta Puhkala & Pipsa Tuominen & Pauliina Husu & Riitta Luoto, 2016. "Effectiveness and Cost-Effectiveness of a Cluster-Randomized Prenatal Lifestyle Counseling Trial: A Seven-Year Follow-Up," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-16, December.

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