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10. Scenario 1: screening for patients for pre-diabetes and diabetes
a. Refers to the current treatment protocol in the HA for all complications. Patients will
be screened on an annual basis, unless they have already been diagnosed with
diabetes. Additional efforts to monitor diabetic patients’ biochemical levels (FPG,
HbA1c) will not be separately accounted for.

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. Patients diagnosed with diabetes without complications are provided with an
annual HKD 3,486/person subsidy to purchase additional services to
manage their diagnosis, matching the subsidy provided for GOPC PPP.
iii. Cost of healthcare services to treat a patient with one or more complications is
HKD 106.5k/person/year. This cost includes the costs of monitoring and
testing for FPG and HbA1c.

iv. The cumulative incidence of complications is 6.20% within a diabetic
population.

c. Patients with diabetes may remit back to having pre-diabetes at a rate of 7.0%
cumulative incidence.

i. Remission cases will also be distributed homogeneously among individuals with
diabetes, with exception to the first year of diabetes history wherein individuals
will not experience mortality or remission.
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.

e. Patients who are not diagnosed with diabetes will undergo regular rescreening.
i. Patients with pre-diabetes will conduct an annual rescreening, given their higher
risk of developing diabetes.
ii. Patients deemed “low-risk” will conduct an annual rescreening once every three
years. The prevalence of low risk is determined as an average of individuals in
each age range who engage in moderate to vigorous physical activity during the
week, as per PHS 2014/15 data. For 45–54 year old patients, the prevalence is
58.8%, for 55–64, it is 56.5%, and for 65–74, it is 52.7%.
iii. Patients deemed “high-risk” will conduct annual rescreening. These are
individuals who do not engage in regular physical activity.

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