Diabetes Self-Management Education and Training - Cost and Comparative Effectiveness

Objective:Cost effectiveness is an economic tool that compares the relative expenditure and outcomes of two or more courses of action; comparative effectiveness means understanding the costs and benefits of different treatment options through research on the relative effectiveness of those options. Understanding of the cost/comparative effectiveness of something should lead to better (or at least the same) outcomes for reduced health care spending.  The problem is that there are gaps in knowledge. We aimed to fill these gaps 

Methods:Analysis using cost- and comparative-effectiveness frameworks to examine quantitative data and findings published in recent studies on diabetes education. 

Results:  Components the key self care behaviors (AADE7) are highly effective for some populations with diabetes. Boren, et al (2009), show that diabetes education is cost-effective, but, lack of consistency across studies has limited the generalizability of the findings about the costs and benefits of the intervention and for whom it is most effective. Duncan, et al (2009), provide comprehensive information about the value of DSME/T, showing the intervention to be cost saving, due to higher pharmaceutical expenditures but less intensive use of costly inpatient.

Conclusion: Studies of comparative effectiveness should not be limited to markedly different treatment options. The studies should evaluate different approaches to the same basic treatment. Rigorous cost- and comparative effectiveness studies help our understanding of whether certain treatment approaches provide benefits that are worth the cost, providing an indication of total value of an intervention.