A computer simulation model for cost-effectiveness analysis of mass screening for Type 2 diabetes mellitus

The cost-effectiveness analysis of mass screening for Type 2 diabetes melli tus (DM) was performed to elucidate whether, who and how often it should be conducted in Taiwan. A series of Markov process was developed to model the disease natural history of Type 2 DM. A hypothetical cohort with 30 000 re sidents aged over 30 years in Taiwan was randomly assigned to three arms of screening regimes, biennial, five-yearly and the control group. A Monteo C arol computer simulation was performed to calculate effectiveness of two sc reening regimes compared with the control group. Direct costs and utilities were incorporated to each corresponding state to calculate the incremental costs per life-years gained and per quality-adjusted life-years (QALYs) fo r biennial and five-yearly screening regimes. The incremental costs for bie nnial screening regime were estimated at $26 750 per life-year gained, and $17 833 per QALY. The corresponding figures for five-yearly screening regim e were $10 531 per Life-year gained and $17 113 per QALY. The incremental c osts per life-year gained and per QALY increase with age, ranging from $17 238 for aged 30-39 years to $54 700 for aged over 70 years and from $9193 t o 36 467, respectively. In conclusion, mass screening for Type 2 DM. especi ally in younger subjects, with 5-year inter-screening interval is cost-effe ctive in Taiwan. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved .