Model-based economic evaluation of the effectiveness of “‘Hypos’ can strike twice”, a leaflet-based ambulance clinician referral intervention to prevent recurrent hypoglycaemia

Smith, MD, Ridyard, C, Botan, V ORCID: https://orcid.org/0000-0003-1583-3913, Brewster, A, Dunmore, S, James, J, Khunti, K, Laparidou, D, Law, G, Mountain, P, Roberts, L, Rowan, E, Spaight, R, Spurr, K and Siriwardena, AN, 2023. Model-based economic evaluation of the effectiveness of “‘Hypos’ can strike twice”, a leaflet-based ambulance clinician referral intervention to prevent recurrent hypoglycaemia. PLOS ONE, 18 (3): e0282987. ISSN 1932-6203

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Abstract

“‘Hypos’ can strike twice” (HS2) is a pragmatic, leaflet-based referral intervention designed for administration by clinicians of the emergency medical services (EMS) to people they have attended and successfully treated for hypoglycaemia. Its main purpose is to encourage the recipient to engage with their general practitioner or diabetic nurse in order that improvements in medical management of their diabetes may be made, thereby reducing their risk of recurrent hypoglycaemia. Herein we build a de novo economic model for purposes of incremental analyses to compare, in 2018–19 prices, HS2 against standard care for recurrent hypoglycaemia in the fortnight following the initial attack from the perspective of the UK National Health Service (NHS). We found that per patient NHS costs incurred by people receiving the HS2 intervention over the fortnight following an initial hypoglycaemia average £49.79, and under standard care costs average £40.50. Target patient benefit assessed over that same period finds the probability of no recurrence of hypoglycaemia averaging 42.4% under HS2 and 39.4% under standard care, a 7.6% reduction in relative risk. We find that implementing HS2 will cost the NHS an additional £309.36 per episode of recurrent hypoglycaemia avoided. Contrary to the favourable support offered in Botan et al., we conclude that in its current form the HS2 intervention is not a cost-effective use of NHS resources when compared to standard NHS care in reducing the risk of hypoglycaemia recurring within a fortnight of an initial attack that was resolved at-scene by EMS ambulance clinicians.

Item Type:	Journal article
Publication Title:	PLOS ONE
Creators:	Smith, M.D., Ridyard, C., Botan, V., Brewster, A., Dunmore, S., James, J., Khunti, K., Laparidou, D., Law, G., Mountain, P., Roberts, L., Rowan, E., Spaight, R., Spurr, K. and Siriwardena, A.N.
Publisher:	Public Library of Science (PLoS)
Date:	2023
Volume:	18
Number:	3
ISSN:	1932-6203
Identifiers:	Number Type 10.1371/journal.pone.0282987 DOI 1769882 Other
Rights:	This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	13 Jun 2023 12:28
Last Modified:	13 Jun 2023 12:28
URI:	https://irep.ntu.ac.uk/id/eprint/49194

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