Outcomes of U.S. and U.K. population at risk for diabetes conditional on the effectiveness of hypothetical intervention
| Outcomes (over 50 years) . | No delay . | 1-year delay . | 3-year delay . | 5-year delay . | 7-year delay . | 9-year delay . |
|---|---|---|---|---|---|---|
| Cumulative incidence of diabetes, % | 67.0 | 63.8 | 58.2 | 53.4 | 49.3 | 45.7 |
| HR versus no delay | — | 0.92 | 0.79 | 0.69 | 0.61 | 0.55 |
| U.S. setting* | ||||||
| Life years | 11.90 | 11.92 | 11.97 | 12.00 | 12.03 | 12.05 |
| (11.64–12.14) | (11.68–12.15) | (11.74–12.17) | (11.79–12.19) | (11.83–12.21) | (11.87–12.22) | |
| Quality-adjusted life expectancy (QALYs) | 9.51 | 9.53 | 9.57 | 9.60 | 9.63 | 9.65 |
| (9.29–9.69) | (9.33–9.71) | (9.39–9.74) | (9.43–9.76) | (9.47–9.77) | (9.50–9.78) | |
| Costs, excluding intervention ($) | 161,457 | 160,069 | 157,737 | 155,856 | 154,311 | 153,020 |
| (156,721–166,781) | (155,468–165,305) | (153,347–162,816) | (151,640–160,803) | (150,239–158,942) | (149,068–157,321) | |
| Δ Life years versus no delay | — | 0.03 | 0.07 | 0.10 | 0.13 | 0.15 |
| (0.01–0.04) | (0.04–0.10) | (0.06–0.15) | (0.07–0.19) | (0.08–0.22) | ||
| Δ QALY versus no delay | — | 0.02 | 0.07 | 0.10 | 0.13 | 0.15 |
| (0.01–0.03) | (0.04–0.09) | (0.07–0.14) | (0.08–0.18) | (0.10–0.21) | ||
| Δ Costs versus no delay, excluding intervention ($) | — | −1,388 | −3,721 | −5,601 | −7,146 | −8,437 |
| (−1,669 to −1,092) | (−4,483 to −2,923) | (−6,757 to −4,395) | (−8,630 to −5,603) | (−10,197 to −6,611) | ||
| Maximum annual cost of intervention to be cost-effective at $100,000/QALY ($) | — | 567 | 1,389 | 1,954 | 2,367 | 2,680 |
| (462–672) | (1,126–1,652) | (1,578–2,331) | (1,904–2,829) | (2,150–3,210) | ||
| U.K. setting† | ||||||
| Life years | 11.43 | 11.45 | 11.49 | 11.52 | 11.54 | 11.56 |
| (11.21–11.63) | (11.25–11.64) | (11.30–11.67) | (11.35–11.68) | (11.38–11.69) | (11.41–11.70) | |
| Quality-adjusted life expectancy (QALYs) | 9.13 | 9.15 | 9.19 | 9.22 | 9.24 | 9.26 |
| (8.97–9.29) | (9.00–9.31) | (9.05–9.33) | (9.09–9.35) | (9.12–9.37) | (9.15–9.38) | |
| Costs, excluding intervention (£) | 38,321 | 38,116 | 37,769 | 37,489 | 37,257 | 37,063 |
| (37,181–39,450) | (37,021–39,200) | (36,756–38,780) | (36,545–38,436) | (36,371–38,149) | (36,226–37,944) | |
| Δ Life years versus no delay | — | 0.02 | 0.06 | 0.09 | 0.11 | 0.13 |
| (0.01–0.03) | (0.04–0.09) | (0.05–0.13) | (0.07–0.17) | (0.08–0.20) | ||
| Δ QALY versus no delay | — | 0.02 | 0.06 | 0.09 | 0.11 | 0.13 |
| (0.01–0.03) | (0.04–0.08) | (0.06–0.12) | (0.08–0.16) | (0.09–0.18) | ||
| Δ Costs versus no delay, excluding intervention (£) | — | −205 | −552 | −832 | −1,064 | −1,257 |
| (−269 to −145) | (−727 to −389) | (−1,098 to −585) | (−1,404 to −745) | (−1,660 to −878) | ||
| Maximum annual cost of intervention to be cost-effective at £20,000/QALY (£) | — | 201 | 491 | 691 | 836 | 947 |
| (151–250) | (367–616) | (513–868) | (619–1,054) | (699–1,195) |
| Outcomes (over 50 years) . | No delay . | 1-year delay . | 3-year delay . | 5-year delay . | 7-year delay . | 9-year delay . |
|---|---|---|---|---|---|---|
| Cumulative incidence of diabetes, % | 67.0 | 63.8 | 58.2 | 53.4 | 49.3 | 45.7 |
| HR versus no delay | — | 0.92 | 0.79 | 0.69 | 0.61 | 0.55 |
| U.S. setting* | ||||||
| Life years | 11.90 | 11.92 | 11.97 | 12.00 | 12.03 | 12.05 |
| (11.64–12.14) | (11.68–12.15) | (11.74–12.17) | (11.79–12.19) | (11.83–12.21) | (11.87–12.22) | |
| Quality-adjusted life expectancy (QALYs) | 9.51 | 9.53 | 9.57 | 9.60 | 9.63 | 9.65 |
| (9.29–9.69) | (9.33–9.71) | (9.39–9.74) | (9.43–9.76) | (9.47–9.77) | (9.50–9.78) | |
| Costs, excluding intervention ($) | 161,457 | 160,069 | 157,737 | 155,856 | 154,311 | 153,020 |
| (156,721–166,781) | (155,468–165,305) | (153,347–162,816) | (151,640–160,803) | (150,239–158,942) | (149,068–157,321) | |
| Δ Life years versus no delay | — | 0.03 | 0.07 | 0.10 | 0.13 | 0.15 |
| (0.01–0.04) | (0.04–0.10) | (0.06–0.15) | (0.07–0.19) | (0.08–0.22) | ||
| Δ QALY versus no delay | — | 0.02 | 0.07 | 0.10 | 0.13 | 0.15 |
| (0.01–0.03) | (0.04–0.09) | (0.07–0.14) | (0.08–0.18) | (0.10–0.21) | ||
| Δ Costs versus no delay, excluding intervention ($) | — | −1,388 | −3,721 | −5,601 | −7,146 | −8,437 |
| (−1,669 to −1,092) | (−4,483 to −2,923) | (−6,757 to −4,395) | (−8,630 to −5,603) | (−10,197 to −6,611) | ||
| Maximum annual cost of intervention to be cost-effective at $100,000/QALY ($) | — | 567 | 1,389 | 1,954 | 2,367 | 2,680 |
| (462–672) | (1,126–1,652) | (1,578–2,331) | (1,904–2,829) | (2,150–3,210) | ||
| U.K. setting† | ||||||
| Life years | 11.43 | 11.45 | 11.49 | 11.52 | 11.54 | 11.56 |
| (11.21–11.63) | (11.25–11.64) | (11.30–11.67) | (11.35–11.68) | (11.38–11.69) | (11.41–11.70) | |
| Quality-adjusted life expectancy (QALYs) | 9.13 | 9.15 | 9.19 | 9.22 | 9.24 | 9.26 |
| (8.97–9.29) | (9.00–9.31) | (9.05–9.33) | (9.09–9.35) | (9.12–9.37) | (9.15–9.38) | |
| Costs, excluding intervention (£) | 38,321 | 38,116 | 37,769 | 37,489 | 37,257 | 37,063 |
| (37,181–39,450) | (37,021–39,200) | (36,756–38,780) | (36,545–38,436) | (36,371–38,149) | (36,226–37,944) | |
| Δ Life years versus no delay | — | 0.02 | 0.06 | 0.09 | 0.11 | 0.13 |
| (0.01–0.03) | (0.04–0.09) | (0.05–0.13) | (0.07–0.17) | (0.08–0.20) | ||
| Δ QALY versus no delay | — | 0.02 | 0.06 | 0.09 | 0.11 | 0.13 |
| (0.01–0.03) | (0.04–0.08) | (0.06–0.12) | (0.08–0.16) | (0.09–0.18) | ||
| Δ Costs versus no delay, excluding intervention (£) | — | −205 | −552 | −832 | −1,064 | −1,257 |
| (−269 to −145) | (−727 to −389) | (−1,098 to −585) | (−1,404 to −745) | (−1,660 to −878) | ||
| Maximum annual cost of intervention to be cost-effective at £20,000/QALY (£) | — | 201 | 491 | 691 | 836 | 947 |
| (151–250) | (367–616) | (513–868) | (619–1,054) | (699–1,195) |
Data are mean (95% CI).
Discounted at 3% and using a cost-effectiveness threshold of $100,000 per QALY.
Discounted at 3.5% and using a cost-effectiveness threshold of £20,000 per QALY; Δ incremental.