@article{5eab5ecdaf494e7e96559141031b3a50,
title = "Cost-effectiveness of a mobile-phone text messaging intervention on type 2 diabetes—A randomized-controlled trial",
abstract = "Aims: To evaluate the cost-effectiveness of a mobile phone text messaging program for people with type 2 diabetes mellitus. Methods: We performed a generalized cost-effectiveness analysis in a randomized controlled trial in Bangladesh. Patients with type 2 diabetes were randomized (1:1) to a text messaging intervention plus standard-care or standard-care alone. Intervention participants received a text message daily for 6 months encouraging healthy lifestyles. Costs to users and the health systems were measured. The EQ-5D-3L was used to measure improvements in health-related quality-adjusted life years (QALYs). Intervention costs were expressed as average cost-effectiveness ratios (cost-per 1% unit-reduction in glycated haemoglobin HbA1c and cost per QALY gained), based on the World Health Organization cost effectiveness and strategic planning (WHO-CHOICE) method. Results: In 236 patients [mean age 48 (SD9.6) years] the adjusted difference in accumulated QALYs between the intervention and the control group over the 6-month period was 0.010 (95%CI: 0.000; 0.021). Additional costs per-patient averaged 24 international dollars (Intl.$), resulting in incremental cost-effectiveness ratios of 38 Intl.$ per % glycated haemoglobin (HbA1c) reduction and 2406 Intl.$ per QALY gained. The total intervention costs for the mobile phone text messaging program was 2842 Int.$. Conclusion: Text messaging might be a valuable addition to standard treatment for diabetes care in low-resource settings and predicted to lead an overall saving in health systems costs. Studies with longer follow-up and larger samples are needed to draw reliable conclusions.",
keywords = "Chronic diseases, Economic evaluation, Health systems, Low- and middle-income countries, Quality-adjusted life years, Willingness-to-pay, mHealth",
author = "Islam, {Sheikh Mohammed Shariful} and Ralph Peiffer and Chow, {Clara K.} and Ralph Maddison and Andreas Lechner and Rolf Holle and Louis Niessen and Michael Laxy",
note = "Funding Information: Funding: This study received funding from the Center for International Health (CIH), Ludwig-Maximilians-Universitat , Munich, Germany, and icddr,b (GR#01,014). We are grateful to ICDDR,B core donors and DAAD, BMZ, and EXCEED for supporting our study. SMSI is funded by a senior research fellowship from Institute for Physical Activity and Nutrition (IPAN), Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. Competing interests: The authors declare that they have no competing interests. Ethical approval: All patients provided written informed consent at enrollment. The study protocol (PR#13,068) was approved by the Research Review Committee and Ethical Review Committee of the International Center for Diarrhoeal Diseases Research, Bangladesh (icccr,b) and received an Ethical Committee waiver from Ludwig-Maximilians-Universit{\"a}t (LMU) and BIHS. The study was conducted in accordance with the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use Guideline for Good Clinical Practice and the Declaration of Helsinki 2008. This trial was registered with the German Clinical Trial Registry (drks.de), DRKS00005188 . Authors' contributions: SMSI, the principal investigator, was involved in the concept, design, and development of the intervention and the instruments, as well as in the reporting aspects of the report. LN, ML, RH involved in the concept, design, selection of instruments and selection of the economic methods in the analyses, RP was responsible for the statistical analyses and the draft of this manuscript. AL, CKC and RM provided substantial expert advice for the statistical analyses and reviewed the manuscript. All authors read and approved the final manuscript. Data availability statement: Data for the study are available from First author upon reasonable request. Trial Registration: German Clinical Trial Registry No. DRKS00005188 . Funding Information: We acknowledge the contribution of Mr. Mathias Hunger of Helmholtz Zentrum Munich in designing the cost-effectiveness analysis. We would like to thank all the participants in this study and the management and staff of BIHS for their overall support. This report was part of the Master's program of RP., This study received funding from the Center for International Health (CIH), Ludwig-Maximilians-Universitat, Munich, Germany, and icddr,b (GR#01,014). We are grateful to ICDDR,B core donors and DAAD, BMZ, and EXCEED for supporting our study. SMSI is funded by a senior research fellowship from Institute for Physical Activity and Nutrition (IPAN), Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. None declared. All patients provided written informed consent at enrollment. The study protocol (PR#13,068) was approved by the Research Review Committee and Ethical Review Committee of the International Center for Diarrhoeal Diseases Research, Bangladesh (icccr,b) and received an Ethical Committee waiver from Ludwig-Maximilians-Universit?t (LMU) and BIHS. The study was conducted in accordance with the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use Guideline for Good Clinical Practice and the Declaration of Helsinki 2008. This trial was registered with the German Clinical Trial Registry (drks.de), DRKS00005188. Authors' contributions: SMSI, the principal investigator, was involved in the concept, design, and development of the intervention and the instruments, as well as in the reporting aspects of the report. LN, ML, RH involved in the concept, design, selection of instruments and selection of the economic methods in the analyses, RP was responsible for the statistical analyses and the draft of this manuscript. AL, CKC and RM provided substantial expert advice for the statistical analyses and reviewed the manuscript. All authors read and approved the final manuscript. Data availability statement: Data for the study are available from First author upon reasonable request. Trial Registration: German Clinical Trial Registry No. DRKS00005188. Publisher Copyright: {\textcopyright} 2019",
year = "2020",
month = mar,
doi = "10.1016/j.hlpt.2019.12.003",
language = "English (US)",
volume = "9",
pages = "79--85",
journal = "Health Policy and Technology",
issn = "2211-8837",
publisher = "Fellowship of Postgraduate Medicine",
number = "1",
}