Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Diabetes Care 31:e35 2008
DOI: 10.2337/dc08-0096
© 2008 by the American Diabetes Association
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hoerger, T. J.
Right arrow Articles by Engelgau, M. M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Hoerger, T. J.
Right arrow Articles by Engelgau, M. M.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Online Letters: Comments and Responses

Cost-Effectiveness of Screening for Pre-Diabetes Among Overweight and Obese U.S. Adults

Response to Wechowski

Thomas J. Hoerger, PHD1, Katherine A. Hicks, MS1, Stephen W. Sorensen, PHD2, William H. Herman, MD, MPH3,4,5, Robert E. Ratner, MD6, Ronald T. Ackermann, MD, MPH7, Ping Zhang, PHD2 and Michael M. Engelgau, MD2

1 Center of Excellence in Health Promotion Economics, RTI International, Research Triangle Park, North Carolina
2 Centers for Disease Control and Prevention, Atlanta, Georgia
3 Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan
4 Department of Epidemiology, University of Michigan Health System, Ann Arbor, Michigan
5 Michigan Diabetes Research and Training Center, University of Michigan Health System, Ann Arbor, Michigan;the
6 MedStar Research Institute, Washington, D.C.
7 Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana

Corresponding author: Thomas J. Hoerger, PhD, RTI International, 3040 Cornwallis Rd., P.O. Box 12194, Research Triangle Park, NC 27709. E-mail: tjh{at}rti.org

We appreciate Dr. Wechowski's interest (1) in our study (2) and agree that it is important to evaluate the cost-effectiveness of screening for pre-diabetes and of diabetes prevention on a country-by-country basis. Cost-effectiveness ratios may vary between countries because of differences in the costs of diabetes intervention, screening, general treatment, and related complications and because of differences in the prevalence of pre-diabetes.

We agree with Dr. Wechowski that the differences between his analysis for the U.K. (3) and our analysis for the U.S. are unlikely due to time horizon. Adding younger cohorts to our analysis may increase the cost-effectiveness ratio somewhat but will have relatively little effect on our overall ratio because so many overweight and obese patients are in the 45–74 years age range that we used in our analysis. Although Dr. Wechowski assumed that a more costly screening strategy was applied, adopting such a strategy would not dramatically increase our cost-effectiveness ratio; we found that doubling screening costs increased the ratio only modestly.

References

  1. Wechowski, J: The cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults (Letter). Diabetes Care 31:e34, 2008. DOI:10.2337/dc07-2363[Free Full Text]
  2. Hoerger TJ, Hicks KA, Sorensen SW, Herman WH, Ratner RE, Ackermann RT, Zhang P, Engelgau MM: The cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults. Diabetes Care 30:2874–2879, 2007[Abstract/Free Full Text]
  3. Wechowski J, McEwan P: Cost-utility of identifying patients with impaired glucose tolerance and their subsequent treatment with intensive lifestyle intervention to delay the onset of type 2 diabetes in the UK setting. Paper presented at the IV Annual Health Technology Assessment Meeting, Barcelona, 17–20 June 2007, Barcelona, Spain

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hoerger, T. J.
Right arrow Articles by Engelgau, M. M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Hoerger, T. J.
Right arrow Articles by Engelgau, M. M.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum