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4.3.6 DISCUSSION

This chapter presents the findings from an economic impact analysis of executing the
Scheme for DM for 30 years, following a target population of individuals aged 45–54 years at
the start of the implementation period. The BIA structure used in this Chapter follows a
30-year time horizon, rather than a shorter period of 5 years, as recommended in the latest
BIA best practices guidelines, in order to capture the full impact of the Scheme as a
population health intervention (Sullivan et al., 2014).

Implementing a population-wide screening voucher and management Scheme for DM will be
cost-saving and reduce preventable mortalities. The Government should therefore consider
adopting a chronic disease screening voucher and management Scheme to fully attain the
financial and demographic benefits described in the BIA model. The proposed programme
would further Hong Kong’s efforts in promoting the family doctor and basic
medicine model wherein patients sustain a routine source of care from a
primary care provider and the health system transitions to a model of
care that is less hospital-centric (FHB, 2008b).

We conclude that implementing the Scheme for individuals aged 45–54 years will result
in long-term cost-savings. Our BIA shows that there are three major benefits of
implementing a comprehensive Scheme encompassing prevention, early screening,
treatment, and management (Table 4.20). Firstly, we note that in implementing such a
Scheme, there are likely to be notable savings to the health system due to fewer DM cases
and subsequently, fewer patients experiencing complications. Secondly, the BIA projects that
there will likely be an additional population demographic benefit of implementing the Scheme
due to a high number of prevented mortality. Thirdly, both percentage savings from Scenario
1 and Scenario 2 indicate that implementing some form of the CDSVMS would
result in a saving of approximately one-third of direct healthcare
spending, relative to if there had been no screening Scheme at all.

Table 4.20
Results of BIA showing savings and prevented mortalities

(HKD million) Base Scenario Scenario 1 Scenario 2
Costs over 30 years 45,346.76 31,362.88 32,845.33
Costs and Savings over 30 years 13,983.87 12,501.43
Savings
% Savings 30.84% 27.57%
Mortality–DM 68,507 32,525 13,757
Mortality–Prediabetes 14,521 21,762 22,133
Mortality Total prevented mortality 28,742 47,138

Cost to prevent one 1,091,190.59 696,794.93
mortality (HKD)

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