OBJECTIVES:

Gestational diabetes mellitus (GDM) is a common issue in pregnancy that contributes to adverse outcomes for the parent and infant. This study evaluated the cost-effectiveness of a coaching intervention delivered by telehealth that aimed to reduce the incidence of GDM

METHODS:

A decision analytic cost-utility model was constructed in treeage pro® to compare usual care during pregnancy to care complemented by a telehealth dietician led coaching intervention. The model timeframe was one year and was undertaken from the health service provider perspective. Data to inform the model was sourced directly from a large quaternary hospital in Brisbane, Australia where the Living Well during Pregnancy (LWdP) program was implemented and further supplemented with literature-based estimates where data had not been directly collected in the trial.

RESULTS:

The cost of providing routine care and the LWdP intervention to pregnant women was calculated to be AUD $22,827 and AUD $22,537, respectively. The effectiveness of LWdP program (0.894 QALYs) was slightly higher compared to routine care (0.893). Therefore, the value of ICER is negative and indicates that the LWdP program is a dominant strategy to reduce GDM in pregnant women. Probabilistic sensitivity analysis using Monte Carlo simulation over 1,000 simulations showed that LWdP intervention is cost-effective over routine care in 99.60% of the trials using a willingness to pay threshold of AUD $50,000.

CONCLUSIONS:

Although the benefits were small, the analysis demonstrated that a telehealth structured lifestyle interventions during pregnancy can be cost saving to the health system when taking into account the additional hospital costs incurred for GDM. This evaluation provides support to introducing preventative interventions for GDM during pregnancy care.