Long-term cost-effectiveness of a mobile health intervention delivered by clinical pharmacists and community health workers for type 2 diabetes management in urban African American and Latinx populations

PURPOSE: Type 2 diabetes imposes a significant economic burden on healthcare systems. Interdisciplinary healthcare teams can offer patient-centered care by integrating medical, behavioral, and social support services. This approach has the potential to lower complication rates while reducing healthcare expenditures. This study evaluated the cost-effectiveness of an evidence-based clinical pharmacist and community health worker team-based mobile health intervention for diabetes adherence support (mDAS), compared to usual care, among urban African American and Latinx individuals with elevated glycated hemoglobin (HbA1c). METHODS: Direct medical costs from a health system perspective and quality-adjusted life-years (QALYs) were compared between the intervention and usual care groups, using a Markov state transition model to simulate the occurrence of cardiovascular and renal complications. Model inputs were derived from published literature and electronic health records. Comprehensive sensitivity and scenario analyses were conducted to assess the robustness of model findings. RESULTS: Compared to usual care, the mDAS intervention resulted in higher QALYs and lower costs over 5-year, 10-year, and lifetime horizons. Incremental QALYs and cost savings were 0.01, 0.03, and 0.17 and $695, $2,393, and $6,829, respectively. Benefits were more pronounced with longer time horizons. Sensitivity analyses indicated that while the magnitude of cost savings diminished as the risk of complications decreased, the intervention consistently resulted in lower costs and higher QALYs. CONCLUSION: The mDAS intervention resulted in cost savings and long-term health benefits, indicating its potential value for policymakers, healthcare systems, and insurers.