Extended Cost-Effectiveness Analysis of Interventions to Improve Uptake of Diabetes Services in South Africa
2024
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes diagnosis and treatment service utilization in South Africa (SA) using extended cost-effectiveness analysis (ECEA). Applying a Markov model over a 45-year period, the analysis compares costs, health benefits, and financial risk protection (FRP) attributes of different CCT strategies, drawing from SA-specific data. Three scenarios were simulated: covering diagnosis services only, treatment services only, and both diagnosis and treatment services. Cost-effectiveness, measured as incremental net monetary benefit (INMB), and FRP outcomes, reported as cases of catastrophic health expenditure (CHE) averted, were assessed across income quintiles and genders. Results indicate that covering both diagnosis and treatment services for the bottom two quintiles yields the highest INMB ($22 per person) and averts the most CHE cases. Additionally, women experience greater FRP benefits than men. The study concludes that a CCT program targeting diabetes services is cost-effective for the poorest 40% of the SA population. ECEA facilitates equity considerations in informing priority setting and policy implementation in SA.
Source:
Fraser HL, Feldhaus I, Edoka IP, Wade AN, Kohli-Lynch CN, Hofman K, Verguet S. Extended Cost-Effectiveness Analysis of Interventions to Improve Uptake of Diabetes Services in South Africa. Health Policy and Planning 2024; 39 (3): 253-267. https://doi.org/10.1093/heapol/czae001