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Table 11
Shifts in costs and savings in Scenario 2 due to different costs for
RAMP-DM implementation

(HKD million) Current cost: RAMP cost: RAMP cost: RAMP cost:
HKD 244 HKD 500 HKD 1,000 HKD 1,500
Costs over 30 years 32,845.33 33,278.19 34,126.68 34,975.17
Savings over 30 years 12,501.43 12,068.57 11,220.08 10,371.59

% Savings 27.57% 26.61% 24.74% 22.87%

Scenario analysis 5: Prediabetes management costs
The latest Hong Kong Reference Framework for Diabetes Care in Adults does not provide
in-depth guidance for the care and management of prediabetes in patients, and hence, the
original model does not account for any extra care protocols for prediabetes within the Base
Scenario and only additionally accounts for annual rescreening costs (Primary Healthcare
Office, 2018). Nonetheless, between the demographic figures in Base Scenario (Table 4.12),
Scenario 1 (Table 4.14), and Scenario 2 (Table 4.15), the size of the population with
prediabetes grows significantly from 104,553 individuals by 2051 in the Base Scenario to
162,967 in Scenario 1 and 168,939 in Scenario 2. These figures represent an increase of
56% and 62%, respectively. Given that the size of the prediabetes population directly impacts
the size of the population with diabetes and that the Reference Framework also suggest
taking measures, such as routine exercise and annual rescreening, to prevent progression
toward diabetes, the Government may consider adding an additional management
component for individuals with prediabetes. In addition to annual rescreening for diabetes
wherein patients may be able to receive additional care resources, an additional scenario
analysis was built to account for one extra routine medical visit to incentivize patients with
prediabetes to better manage their condition. This is represented as an additional HKD 350
(the average cost of one visit according to the GOPC PPP subsidy) for each patient with
prediabetes in both Scenario 1 and Scenario 2 (Table 12). We note that the cost-savings
percentage remains above 20% even in Scenario 2, suggesting that the additional benefit to
prediabetic patients would still lead to cost savings to the health system, even prior to the
indirect and direct benefits that may be accrued from providing additional care for
prediabetes.

Table 12

Shifts in cost and savings due to prediabetes management costs

(HKD million) Base Scenario Scenario 1 Scenario 2
Costs over 30 years 45,346.76 32,630.13 34,134.16
Savings over 30 years 12,716.63 11,212.60
% Savings 28.04% 24.73%

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