Private Diabetes Care Delivery in Iran, is it Cost-Effective?

Abstract BackgroundThe quality of health care provided to diabetic patients has a significant impact on long-term costs and health outcomes. This study aims to determine the long-term cost-effectiveness analysis between private and public Diabetic Centers in Iran.MethodsUsing the localized UKPDS model, we performed a cost-effectiveness analysis to forecast 20 years quality-adjusted life expectancy (QALE) gains and direct medical costs(management of complications and Treatment Costs) in under-treatment patients referred to private and public Diabetic Centers in Iran. Costs and utility decrements derived from 1978 patients with type 2 diabetes from 7 private and eight Public diabetes centers in 5 provinces. We used statistical techniques (internal loops (Monte-Carlo trials) and bootstraps) to examine the robustness of the results.ResultsIn a 20-year time horizon, the private sector will be more effective and more costly(5.17 vs 4.95 QALE and 15385 vs 8092 ). The incremental cost-effectiveness ratio (ICER) was $33,148.02 per QALE gained that was higher than our country threshold.Conclusion Although the pattern and quality of care in private-sector diabetes centers resulted in a slight increase in the life expectancy of T2DM patients, it is associated with unfavorable costs too.