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Published in: The European Journal of Health Economics 3/2020

01-04-2020 | Diabetic Neuropathy | Original Paper

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

Authors: B. Rodríguez-Sánchez, L. M. Peña-Longobardo, A. J. Sinclair

Published in: The European Journal of Health Economics | Issue 3/2020

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Abstract

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.
Appendix
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Footnotes
1
The Markov model was constructed using Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) to emulate the different clinical pathways that can be developed once a person with diabetes has been diagnosed with neuropathy [26].
 
2
We did not define comorbidities (as we neither defined age, nationality and functional status) as the inclusion of these would have complicated the analysis unnecessarily and made the interpretation of the findings very difficult and unlikely to allow us to find clear conclusions. Any of the seven health states considered could apply to people with diabetes of any age since as many as 20% of newly diagnosed people with type 2 diabetes have signs of neuropathy at diagnosis. However, those with an ulcer or a history of amputation are likely to have had diabetes for at least 10 years, irrespective of the duration of neuropathy remembering that vascular disease may be the more predominant cause.
 
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Metadata
Title
Cost-effectiveness analysis of the Neuropad device as a screening tool for early diabetic peripheral neuropathy
Authors
B. Rodríguez-Sánchez
L. M. Peña-Longobardo
A. J. Sinclair
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 3/2020
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-019-01134-2

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