Presentation (CTI)

OBJECTIVES: Type 2 diabetes (T2D) affects more than 4 million people in France and represents a major public health burden. Despite recommendations from the French National Authority for Health (HAS) for regular screening of individuals at risk, diagnosis often occurs late, with 28% of patients identified only after hospitalization for diabetes-related complications. Earlier detection of prediabetes may delay disease progression and reduce long-term healthcare costs. This study aims to assess the cost-effectiveness and budget impact of a systematic screening strategy combining FINDRISC assessment and blood glucose testing in at-risk individuals compared with current practice in France.
METHODS: A literature review (PubMed, 2010-2026) identified economic evaluations and transition probabilities for T2D. Two Markov models compared current practice with organized screening using annual cycles, a 20-year horizon, a French National Health Insurance perspective, and a 2.5% discount rate. Health states included prediabetes, diabetes, diabetes-related complications, and death. Costs included screening (€9), diabetes management (€1,996.58/year), and complications (€9,011/year). Outcomes were costs and quality-adjusted life years (QALYs). A national budget impact analysis was performed over 10 years.
RESULTS: In a cohort of 100,000 individuals, organized screening generated 1.481 million QALYs and total costs of €485 million, compared with 1.476 million QALYs and €604 million under current practice. Screening was dominant, providing savings of €119 million and a gain of 4,387 QALYs. At the national level, assuming an at-risk population of 18.5 million and increased screening uptake from 30% to 45% by year 4, organized screening reduced healthcare expenditure from €22 billion to €21.5 billion over 10 years, representing €572 million in savings.
CONCLUSIONS: Systematic screening of at-risk individuals for T2D appears to be a dominant strategy, improving health outcomes while reducing healthcare expenditures. Expanding screening coverage could generate substantial long-term savings for the French healthcare system.Haut du formulaire