Cost-Effectiveness of Interventions for Preventing and Treating Diabetes and Its Complications in Developing Regions | Cost/QALY (2001 US$) | | |
| Intervention | East Asia and the Pacific | Europe and Central Asia | Latin America and the Caribbean | Middle East and North Africa | South Asia | Sub-Saharan Africa | Feasibilitya | Implementing priorityb |
| Level 1 |
| Glycemic control in people with HbA1c higher than 9 percent | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | ++++ | 1 |
| Blood pressure control in people with pressure higher than 160/95 mmHg | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | ++++ | 1 |
| Foot care in people with a high risk of ulcers | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | ++++ | 1 |
| Level 2 |
| Preconception care for women of reproductive age | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | Cost saving | ++ | 2 |
| Lifestyle interventions for preventing type 2 diabetes | 80 | 100 | 130 | 110 | 60 | 60 | ++ | 2 |
| Influenza vaccinations among the elderly for type 2 diabetes | 220 | 290 | 360 | 310 | 180 | 160 | ++++ | 2 |
| Annual eye examination | 420 | 560 | 700 | 590 | 350 | 320 | ++ | 2 |
| Smoking cessation | 870 | 1,170 | 1,450 | 1,230 | 730 | 660 | ++ | 2 |
| ACE inhibitor use for people with diabetes | 620 | 830 | 1,020 | 870 | 510 | 460 | +++ | 2 |
| Level 3 |
| Metformin intervention for preventing type 2 diabetes | 2,180 | 2,930 | 3,630 | 3,080 | 1,820 | 1,640 | ++ | 3 |
| Cholesterol control for people with total cholesterol higher than 200 milligrams/deciliter | 4,420 | 5,940 | 7,350 | 6,240 | 3,680 | 3,330 | +++ | 3 |
| Intensive glycemic control for people with HbA1c higher than 8 percent | 2,410 | 3,230 | 4,000 | 3,400 | 2,000 | 1,810 | ++ | 3 |
| Screening for undiagnosed diabetes | 5,140 | 6,910 | 8,550 | 7,260 | 4,280 | 3,870 | ++ | 3 |
| Annual screening for microalbuminuria | 3,310 | 4,450 | 5,510 | 4,680 | 2,760 | 2,500 | ++ | 3 |
Source: Authors.
a. Feasibility was assessed based on difficulty of reaching the intervention population (the capacity of the health care system to deliver an intervention to the targeted population), technical complexity (the level of medical technologies or expertise needed for implementing an intervention), capital intensity (the amount of capital required for an intervention), and cultural acceptability (appropriateness of an intervention in terms of social norms and/or religious beliefs). ++++ indicates feasible for all four aspects, +++ indicates feasible for three of the four, ++ indicates feasible for two of the four, and + indicates feasible for one of the four.
b. Implementing priority was assessed by combining the cost-effectiveness of an intervention and its implementation feasibility; 1 represents the highest priority and 3 represents the lowest priority.
