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Economic evaluation of diabetes prevention interventions in Bangladesh : A modelling study

Mohebbi, Damon ; Shaha, Sanjit Kumar ; Kuddus, Abdul ; Chowdhury, Md Alimul Reza ; Jennings, Hannah ; Ahmed, Naveed ; Morrison, Joanna ; Akter, Kohenour ; Nahar, Tasmin and King, Carina , et al. (2026) In Diabetes and Metabolic Syndrome: Clinical Research and Reviews 20(1).
Abstract

Aim: To model the long-term cost-effectiveness of scaling up two prevention interventions against type 2 diabetes mellitus (T2DM), i.e. community mobilisation through participatory learning and action (PLA) and mHealth mobile phone messaging, implemented in rural Bangladesh as part of the “DMagic” trial. Methods: A health-economic Markov model of the three-arm, cluster-randomised controlled DMagic trial was developed. A cohort of individuals aged 50 years entered the model with impaired glucose tolerance (IGT). Outcomes included the costs (provider perspective), quality-adjusted life-years gained (QALY), incremental cost-effectiveness ratios (ICERs) and incidence of T2DM in a lifetime period. Deterministic and probabilistic sensitivity... (More)

Aim: To model the long-term cost-effectiveness of scaling up two prevention interventions against type 2 diabetes mellitus (T2DM), i.e. community mobilisation through participatory learning and action (PLA) and mHealth mobile phone messaging, implemented in rural Bangladesh as part of the “DMagic” trial. Methods: A health-economic Markov model of the three-arm, cluster-randomised controlled DMagic trial was developed. A cohort of individuals aged 50 years entered the model with impaired glucose tolerance (IGT). Outcomes included the costs (provider perspective), quality-adjusted life-years gained (QALY), incremental cost-effectiveness ratios (ICERs) and incidence of T2DM in a lifetime period. Deterministic and probabilistic sensitivity analyses were performed to reflect uncertainty. Results: PLA yielded substantial reductions in diabetes incidence with only 25 % of the IGT population developing T2DM (versus 46 % in the control arm). The intervention was cost-effective against control with an ICER of 167 INT$ per QALY gained. The mHealth intervention revealed limited effectiveness at low cost, leading to an ICER of 189 INT$ per QALY gained. At willingness-to-pay ranges between 3 % and 45 % of Bangladesh GDP per capita, PLA demonstrated up to 90 % probability of being cost-effective. Conclusions: PLA is a low-cost, effective strategy to reduce the burden of T2DM, offering good value for money. Trial registration: The DMagic trial was registered with the ISRCTN registry, number ISRCTN41083256.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Community mobilisation, Cost-effectiveness, Diabetes prevention, DMagic, Impaired glucose tolerance, Markov model
in
Diabetes and Metabolic Syndrome: Clinical Research and Reviews
volume
20
issue
1
article number
103370
publisher
Diabetes India
external identifiers
  • pmid:41539161
  • scopus:105027392957
ISSN
1871-4021
DOI
10.1016/j.dsx.2025.103370
language
English
LU publication?
yes
id
27b1987c-b285-4063-8c20-23e499026d22
date added to LUP
2026-03-16 15:33:37
date last changed
2026-03-16 15:34:50
@article{27b1987c-b285-4063-8c20-23e499026d22,
  abstract     = {{<p>Aim: To model the long-term cost-effectiveness of scaling up two prevention interventions against type 2 diabetes mellitus (T2DM), i.e. community mobilisation through participatory learning and action (PLA) and mHealth mobile phone messaging, implemented in rural Bangladesh as part of the “DMagic” trial. Methods: A health-economic Markov model of the three-arm, cluster-randomised controlled DMagic trial was developed. A cohort of individuals aged 50 years entered the model with impaired glucose tolerance (IGT). Outcomes included the costs (provider perspective), quality-adjusted life-years gained (QALY), incremental cost-effectiveness ratios (ICERs) and incidence of T2DM in a lifetime period. Deterministic and probabilistic sensitivity analyses were performed to reflect uncertainty. Results: PLA yielded substantial reductions in diabetes incidence with only 25 % of the IGT population developing T2DM (versus 46 % in the control arm). The intervention was cost-effective against control with an ICER of 167 INT$ per QALY gained. The mHealth intervention revealed limited effectiveness at low cost, leading to an ICER of 189 INT$ per QALY gained. At willingness-to-pay ranges between 3 % and 45 % of Bangladesh GDP per capita, PLA demonstrated up to 90 % probability of being cost-effective. Conclusions: PLA is a low-cost, effective strategy to reduce the burden of T2DM, offering good value for money. Trial registration: The DMagic trial was registered with the ISRCTN registry, number ISRCTN41083256.</p>}},
  author       = {{Mohebbi, Damon and Shaha, Sanjit Kumar and Kuddus, Abdul and Chowdhury, Md Alimul Reza and Jennings, Hannah and Ahmed, Naveed and Morrison, Joanna and Akter, Kohenour and Nahar, Tasmin and King, Carina and Palmer, Tom and Hunter, Rachael and Kiadaliri, Ali and Azad, Kishwar and Fottrell, Edward and Haghparast-Bidgoli, Hassan}},
  issn         = {{1871-4021}},
  keywords     = {{Community mobilisation; Cost-effectiveness; Diabetes prevention; DMagic; Impaired glucose tolerance; Markov model}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Diabetes India}},
  series       = {{Diabetes and Metabolic Syndrome: Clinical Research and Reviews}},
  title        = {{Economic evaluation of diabetes prevention interventions in Bangladesh : A modelling study}},
  url          = {{http://dx.doi.org/10.1016/j.dsx.2025.103370}},
  doi          = {{10.1016/j.dsx.2025.103370}},
  volume       = {{20}},
  year         = {{2026}},
}