Health Promotion International, Vol. 2, No. 4, 331-340, 1987
© Oxford University Press 1987
research-article |
The cost-utility of diet and exercise interventions in non-insulin-dependent diabetes mellitus
Center for Behavioral Medicine, San Diego State University and Department of Community and Family Medicine, University of California San Diego, California, USA Department of Pediatrics, University of California San Diego, California, USA Department of Psychology, Vanderbilt University Nashville, Tennessee, USA Substantial evidence suggests that obesity is associated with non-insulin-dependent diabetes mellitus (NIDDM) and that weight reduction precedes improvements in glucose intolerance. However, achieving weight loss requires labour-intensive behavioural interventions. We evaluated the cost-utility of behavioural interventions in an experimental study of 76 NIDDM adults. In comparison with an education control group, adults randomly assigned to a diet-plus-exercise programme showed significant improvement in health status over an eighteen-month period. Using a general health policy model, we estimated that the programme produced 0.092 well-years for each participant. Programme costs were estimated using usual charges for physical examinations, blood tests, ECG evaluations, behaviour modification, and medical supervision. These costs totalled approximately US $1000 per participant. The cost-utility ratio was US $1000/0.092 = $10 870 per well-year. Using the general health policy model, the cost-utility of the behavioural intervention programmes was shown to be competitive with other widely advocated medical interventions.