{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:49:19Z","timestamp":1791434959731,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["CFS\u2010HKU4"],"award-info":[{"award-number":["CFS\u2010HKU4"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The Risk Assessment and Management Programme\u2014Diabetes Mellitus (RAMP\u2010DM) is a multidisciplinary, protocol\u2010driven, risk\u2010stratified care model integrated into public primary care in Hong Kong for patients with type 2 diabetes mellitus (T2DM). This study evaluated the real\u2010world 10\u2010year cost\u2010effectiveness of RAMP\u2010DM from the public healthcare provider perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Programme costs from 2009 to 2019 were estimated using costing questionnaires and reported in 2019 US dollars. Direct medical costs were compared between patients enrolled in RAMP\u2010DM and a propensity\u2010score matched cohort receiving usual care only. Effectiveness was based on previously published 10\u2010year estimates of absolute risk reduction in complications and all\u2010cause mortality. The primary outcome was the incremental total direct medical cost per diabetes\u2010related complication avoided over 10\u2009years. Secondary outcomes included incremental cost per all\u2010cause mortality avoided and programme cost per complication avoided. Sensitivity analyses examined the effects of parameter uncertainty and discounting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 36\u2009746 patients (18\u2009373 in each group) were included. RAMP\u2010DM was associated with absolute risk reductions of 12.1% for any complications and 16.2% for all\u2010cause mortality. Accounting for the programme cost of US$329 per participant, total undiscounted direct medical costs over 10\u2009years was US$10\u2009543 lower per person among RAMP\u2010DM participants (RAMP\u2010DM: $23\u2009430; usual care: US$33\u2009973). RAMP\u2010DM was a cost\u2010saving strategy relative to usual care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RAMP\u2010DM was associated with better 10\u2010year clinical outcomes and lower direct medical costs. These findings support the economic value of structured multidisciplinary diabetes management programmes in publicly funded primary care settings, although residual confounding and uncertainty in cost estimates should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71242","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:48:29Z","timestamp":1787550509000},"page":"10379-10389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ten\u2010Year Cost\u2010Effectiveness of the Risk Assessment and Management Programme\u2014Diabetes Mellitus (\n                    <scp>RAMP<\/scp>\n                    \u2010\n                    <scp>DM<\/scp>\n                    ) Relative to Usual Care in Hong Kong Public Primary Care: A Population\u2010Based Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4196-8686","authenticated-orcid":false,"given":"Eric Ho Man","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"},{"name":"School of Public Health, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy Lynn","family":"Mak","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Tsui Yee","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Yee Tak","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"},{"name":"Primary Healthcare Commission Health Bureau, The Government of the Hong Kong Special Administrative Region  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Yun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weng Yee","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR 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