{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:45:26Z","timestamp":1792028726432,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR200933"],"award-info":[{"award-number":["NIHR200933"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/24\/130017"],"award-info":[{"award-number":["RE\/24\/130017"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n \n The National Health Service (NHS) offers\n Healthy Living<\/jats:italic>\n , an online Diabetes Self\u2010Management Education and Support service, to help people Self Manage Type 2 Diabetes, with modest 1\u2010year reductions in HbA1c levels, systolic blood pressure and body mass index. We aim to assess the cost\u2010effectiveness of\n Healthy Living<\/jats:italic>\n compared with usual care.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A patient\u2010level economic simulation model (UKPDS\u2010OM2.1) was used to conduct an economic analysis from the NHS perspective over a lifetime horizon, discounted at 3.5%. The model translated risk factor reductions to long\u2010term cost and quality\u2010adjusted life year (QALY) estimates. Additional analyses estimated intervention and medication cost consequences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The UKPDS\u2010OM2.1 predicted a modest improvement in health (0.016 QALYs) and a small reduction in lifetime healthcare costs (\u2212\u00a34 per person). Offsetting with intervention costs (\u00a37 per user) and increased medication costs (\u00a3212 per user) yielded a net cost of \u00a3216 per user. The cost\u2010per\u2010QALY of \u00a313,192 was below the lower NICE threshold (\u00a325,000\/QALY), indicating that the programme is cost\u2010effective. Sensitivity analyses largely demonstrated robustness, but the finding was sensitive to structural assumptions about disease progression post\u2010intervention with the inclusion of medication costs.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Healthy Living<\/jats:italic>\n appears to be a low\u2010cost, online intervention for self managing type 2 diabetes, generating modest health benefits that are likely to be considered cost\u2010effective use of NHS resources. While there is some uncertainty in the cost\u2010effectiveness and the modelling is based on effectiveness estimated from observational data, improvements in uptake and adherence has the potential to improve the value for money to the NHS.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dme.70490","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:10:46Z","timestamp":1792026646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the long\u2010term cost\u2010effectiveness of a free online Diabetes Self\u2010Management Education and Support service in England:\n Healthy living for people with type 2 diabetes<\/i>\n , using a matched cohort study design"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1117-0334","authenticated-orcid":false,"given":"Luke","family":"Paterson","sequence":"first","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"},{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7978-1094","authenticated-orcid":false,"given":"Salwa S.","family":"Zghebi","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6450-5815","authenticated-orcid":false,"given":"Evangelos","family":"Kontopantelis","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences The University of Manchester Manchester UK"},{"name":"Yong Loo Lin School of Medicine National University of Singapore Singapore City Singapore"},{"name":"National University of Singapore Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5136-390X","authenticated-orcid":false,"given":"Sarah","family":"Cotterill","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Lowndes","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0683-3877","authenticated-orcid":false,"given":"Brian","family":"McMillan","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin K.","family":"Rutter","sequence":"additional","affiliation":[{"name":"School of Medical Sciences The University of Manchester Manchester UK"},{"name":"Manchester University NHS Foundation Trust Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3650-0168","authenticated-orcid":false,"given":"Rachel A.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"National Institute for Health and Care Excellence.Type 2 diabetes in adults: management (NICE Guideline 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