OBJECTIVES: This study assesses the cost-effectiveness of vitamin D and Omega-3 supplements on HbA1C levels to reduce prediabetes and diabetes risks in PCOS-diagnosed females.

METHODS: A simple Markov model simulated a PCOS (Polycystic Ovary Syndrome) population for seven total 8-week cycles including the following states based on HbA1C levels: normal glucose tolerance, prediabetic, and type 2 diabetic. Costs were analyzed in 2023 US dollars from a healthcare and societal perspective using estimates with an annual discount rate of 3%. Individuals could transition bidirectionally between states, with death as the final state. Transition states were estimated from previous studies and weights were applied for each treatment group. With 5% effectiveness applied for single dose of both vitamin D and Omega 3 and 10% effectiveness applied to co-supplementation. Quality-adjusted life years were pulled from previous work which applied a calculation based on SF-12 scores and a willingness-to-pay threshold of $100,000 was applied to the model.

RESULTS: Base case analysis results showed that vitamin D and co-supplementation were dominant strategies when applied to a comprehensive perspective including both healthcare and societal costs. Vitamin D had the lowest treatment cost for the 56 weeks when compared to all other treatment groups with a total cost of $357.39. However, base case analysis resulted in incremental cost effectiveness ratios less than or equal to zero for both no treatment and Omega-3 (No Treatment: -279529.75; Omega 3: 0.00). Effectiveness results showed all treatment options having an effectiveness of 0.76 QALY, with all groups have a 0.00 incremental effectiveness when compared to Vitamin D. A probabilistic sensitivity analysis indicates no treatment as optimal in 97.30% of 1,000 simulations.

CONCLUSIONS: Vitamin D and co-supplementation were dominant strategies compared to no treatment and Omega 3. When a $100,000 WTP threshold was used, all treatments yielded positive net monetary benefits, compared with Vitamin D.