OBJECTIVES: This study assessed the cost-effectiveness of LISTEN (Low-Intensity mental health Support via a Telehealth Enabled Network) for adults experiencing diabetes distress, facilitated by diabetes health professionals. METHODS: A within-trial cost-utility analysis included 428 participants randomised to either LISTEN (diabetes-specific problem-solving therapy) or usual care (web-based diabetes distress and generic mental health resources). Quality-adjusted life-years (QALYs) were derived using the Assessment of Quality of Life-4D (AQoL-4D). Costs were measured from health sector and societal perspectives using a self-reported resource use questionnaire. Incremental cost-effectiveness ratios (ICERs) were calculated and non-parametric bootstrapping estimated 95% confidence intervals. Costs were presented in Australian dollars (A) for the 2021-22 financial year. RESULTS: The mean direct cost of delivering LISTEN was A262 per person. Over 6 months, the LISTEN group had higher total QALYs (0. 024; 95% CI 0. 007 to 0. 041). Compared to usual care, mean health sector cost (-A3, 271; 95% CI -A5, 134 to A1, 008) and societal cost (-A3, 588; 95% CI -A5, 913 to A860) were lower, although these differences were not statistically significant. At a A50, 000 per QALY willingness-to-pay threshold, LISTEN was dominant with a 94% probability of being cost-effective from both perspectives. Findings should be interpreted cautiously given the substantial missing data. CONCLUSION: LISTEN significantly improves health-related quality of life of adults with diabetes distress and is likely to be cost-effective. Point estimates show lower mean costs alongside QALY gains, but cost differences were not statistically significant.
Perez et al. (Fri,) studied this question.