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Even more promisingly, the cost-effectiveness analysis (CEA) comparing the two care
protocols revealed that RAMP-DM care was substantially more cost-effective
than usual care. The cost reduction was driven by more effective preventive
interventions at earlier stages of disease and more timely holistic
treatment. The estimated cost for RAMP-DM care was far less than usual care, costing
the health system approximately HKD 19,137 per patient annually compared to an estimated
HKD 30,515 for usual care (Jiao et al., 2018). The economic analyses also revealed that while
initial investment of RAMP-DM care is higher than usual care by HKD 1,225 per patient, the
upfront cost is offset by the reduction in health service utilisation and subsequently, reduction
in costs for hospitalisation associated with DM-related complications (Jiao et al., 2018).

The available studies on the effectiveness and benefits of RAMP-DM reiterate the importance
of taking up a multifaceted approach to reduce the overall incidence of diabetic
complications, hospitalisations, and premature mortality. In particular, these studies illustrate
both clinical and cost effectiveness, which builds the case for earlier diagnosis and effective
management of DM. The history and development of RAMP-DM are further explored in
Appendix L.

Table 4.8
Overview of studies evaluating intervention strategies for diabetic care

Title Overview of Study & Key Findings
From Hong Kong Diabetes Register (a) Historical practice of gathering structured data-related to
(HKDR) to Joint Asia Diabetes DM care in Hong Kong highlights the importance of
Evaluation (JADE) Program to Risk technological integration in prediction of clinical
Assessment and Management outcomes, reducing clinic inertia, and empowering
Programme–Diabetes Mellitus self-management;
(RAMP-DM) for Data–Driven (b) Generation of big data on DM care enabled the
Actions (Chan et al., 2019) identification of patients’ unmet needs and evaluation of
intervention strategies to periodically inform integrated
DM care programmes supported by data-driven action;
(c) RAMP-DM care is a proven example that combines
UHC, public-private partnership (PPP), and data-driven
integrated care, and benefits 0.4 million people in Hong
Kong with DM.
Five-Year Effectiveness of the Clinical effectiveness of RAMP care vs. usual care
Multidisciplinary RAMP-DM on (a) RAMP-DM care can substantially reduce the risk of
Diabetes-Related Complications disease complications from 43.6% (usual care group) to
and Health Service Uses-A 23.2% and delay disease progression;
Population-Based and
Propensity-Matched Cohort Study (b) Highlights the importance of optimal early
(Wan et al., 2018) intervention in DM patients which can be achieved
through RAMP care.
Five-Year Cost-effectiveness of the Cost-effectiveness of RAMP care vs. usual care
Multidisciplinary Risk Assessment (a) Estimated cost of health care utilisation for RAMP-DM
and Management Programme– care is substantially less than usual care, resulting in a
Diabetes Mellitus (RAMP-DM) net saving of USD 7,451 (HKD 58,118);
(Jiao et al., 2018)
(b) Economic analyses revealed that while initial investment
of RAMP-DM care is higher than usual care by USD 157
(HKD 1,225), the upfront cost is offset by the reduction of
overall health service utilisation, especially through cost
saved with the reduction of DM-related complications;
(c) RAMP-DM is therefore a cost-saving intervention in the
management of DM to reduce disease complication.

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