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Modelling:
6. Screening services are assumed to take place in the private sector and subsidised with
vouchers covering the total cost of screening. The voucher and the total cost of
screening, encompassing between one to two rounds of (FPG & HbA1c) tests and/or
(FPG & HbA1c & OGTT) tests, will amount to HKD 200/person/year.
a. All individuals in the target age range will go through the screening process to be
accounted for and to receive a diagnosis within Scenarios 1 and 2. All individuals that
are not diagnosed with diabetes will engage in regular rescreening, with intervals
dependent on risk level.
7. Complications are assumed to be homogeneous:
a. Patients with 1–5 years of diabetes history are assumed to have no complications.
Patients with 6–19 years of diabetes history are faced with a set complications rate.
Patients with 20+ years of diabetes history experience an average multiplier on their
complications rate of 1.5x.
8. Total costs for the health system will comprise of the cost of treatment for complications
(including screening costs and costs of DM intervention for Scenario 1 and 2).
a. Patients with one or more complications will have an annual average cost of
treatment for complications (see below).
b. Patients without complications will incur a standard average annual fee (see below).
9. Base Scenario: No Screening and Guideline treatment
a. Refers to the current treatment and diagnosis pathway for diabetic patients. Patients
may be screened for diabetes during the course of their usual healthcare services.
b. Costs include:
i. Average yearly cost of standard care for DM management without complications
is HKD 5.7k/person. This figure progresses to HKD 9.3k/person in years
2032–2041, and HKD 15.1k/person in years 2041–2051.
ii. Cost of healthcare services to treat a patient with one or more complications is
HKD 106.5k/person/year.
iii. The cumulative incidence of complications is 6.20% within a diabetic
population.
c. Patients find out about their DM status through opportunistic screening (after
development of complications due to DM or co-morbid conditions with DM)
i. No proactive screening for DM
ii. Regardless of diagnosis, patients will not incur costs to the health system until
they have diabetes, at which point they will incur HKD 5.7k/person/year to the
health system. If they have one or more complications, they will incur HKD 106.5/
person/year.
d. Patients will be exposed to different mortality rates at different age demographics.
For the first ten years, the mortality rate is 0.85% and increases to 1.86% for the
second 10 years of the time horizon, and finally to 4.27% for the last ten years.
i. Patients will also be exposed to different mortality rates due to comorbidity with
pre-diabetes. The mortality rate is 0.50% for the first ten years at ages 45–54,
and then 0.75% for the next ten years at ages 55–64.
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