Wang Yanshang, Guo Dan, Xia Yiqi, Hu Mingzheng, Wang Ming, Shi Zhenyu, Guan Xiaolong, Zhu Dawei, He Ping
School of Public Health, Peking University, Beijing, China.
China Center for Health Development Studies, Peking University, Beijing, China.
Nat Commun. 2025 Mar 27;16(1):2986. doi: 10.1038/s41467-025-58120-x.
The coexistence of type 2 diabetes (T2DM) and depression is a prominent example of multimorbidity. In previous work, we reported the results of a completed cluster-randomized controlled trial that was conducted in eight community health centers in China. We enrolled adults (≥18 years) with type 2 diabetes and depressive symptoms. In the intervention group, a comprehensive care plan was developed based on the Integrated Care Model for Patients with Diabetes and Depression (CIC-PDD). In this study, we explore the cost-effectiveness of the CIC-PDD by conducting a one-year within-trial economic evaluation from the health system, multipayer and societal perspectives. Health outcomes are quality-adjusted life years (QALYs) and depression-free days (DFDs), and we calculate incremental cost-effectiveness ratios (ICERs) and cost-effectiveness probability. Among 630 participants (275 intervention, 355 usual care), the cost per QALY gained is $7,922.82, $7,823.85, and $7,409.46, with cost-effectiveness probabilities of 66.41%- 94.45%. The cost per DFD is $2.63-$2.82, requiring a willingness-to-pay of $9.00-$10.50 for >95% probability of cost-effectiveness. We find that the CIC-PDD model demonstrates cost-effectiveness within primary health care settings, but further studies are needed to assess its long-term sustainability and scalability. Trial registration: 35 ChiCTR2200065608.
2型糖尿病（T2DM）与抑郁症并存是共病的一个突出例子。在之前的工作中，我们报告了在中国八个社区卫生中心进行的一项已完成的整群随机对照试验的结果。我们纳入了患有2型糖尿病和抑郁症状的成年人（≥18岁）。在干预组中，基于糖尿病与抑郁症患者综合照护模型（CIC-PDD）制定了综合照护计划。在本研究中，我们从卫生系统、多支付方和社会角度进行了为期一年的试验内经济评估，以探讨CIC-PDD的成本效益。健康结局为质量调整生命年（QALYs）和无抑郁天数（DFDs），我们计算了增量成本效益比（ICERs）和成本效益概率。在630名参与者中（275名干预组，355名常规照护组），每获得一个QALY的成本分别为7922.82美元、7823.85美元和7409.46美元，成本效益概率为66.41%-94.45%。每增加一个DFD的成本为2.63-2.82美元，成本效益概率>95%时需要的支付意愿为9.00-10.50美元。我们发现CIC-PDD模型在初级卫生保健环境中显示出成本效益，但需要进一步研究来评估其长期可持续性和可扩展性。试验注册：35 ChiCTR2200065608。
