Evaluating Cost-Effectiveness of Public and Private Healthcare for Type 2 Diabetes Mellitus in India

Ajit Jaiswal, International Institute for Population Sciences (IIPS)
Manoj Alagarajan, International Institute for Population Sciences (IIPS)

Type 2 Diabetes Mellitus is a growing global health concern. Its increasing prevalence in India, coupled with substantial kidney and eye problems, and inadequate economic evaluations, highlights the need for comprehensive assessment. This study aims to evaluate public and private facilities in India using a de novo cost-effective model, analyzing clinical, economic, and humanistic outcomes for T2DM treatment. Decision tree and Markov models were employed to estimate the lifetime health outcomes and resulting costs among Indian T2DM patients, aged 45 years and above. Additionally, a one-way sensitivity analysis was utilized to assess uncertainty. The real-world data for model input were accessed through a systematic literature review process. Total cost of treating T2DM is estimated around INR 2,05,420, and INR 3,74,974; QALYs are 4.45 and 5.02 years in public and private facilities, respectively. The additional cost (INR 169,554), and QALYs (0.57) of private facilities, leading to the ICUR of INR 2,98,219/QALY. The uncertainty analysis showed that a 10% increase in T2DM drug costs would raise the burden by 8.12% in public and 7.48% in private facilities. The study finds T2DM treatment cost-effective in private facilities, but it may not be as cost-effective when compared to the willingness-to-pay threshold.

Keywords: Economic Demography, Econometrics , Population Ageing, Simulation

See extended abstract.