Apologies, I was looking at the total number. Still, a 20% drop-out rate is pretty high to not be mentioned on their website, particularly when the drop-outs appear to be much less healthy at baseline!
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Replying to @GidMK
Dropout rate was 17% vs 10% in usual care group, with unchanged treatment so if you could get those benefits in 83% of 1,000,000 of patients 500,000 patients would no longer have diabetes! Now that would be fantastic for all concerned
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Replying to @akmcintyre
The obvious difficulty we struggle with would be the population, many of whom don't speak english or own smartphones
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Replying to @GidMK @akmcintyre
The other obvious issue being funding for intensive lifestyle modification programs like this - we are currently applying for such but the cost per patient is very high and hard to get!
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Replying to @GidMK @akmcintyre
To put it another way - if we treated 1,000,000 people with Virta, we'd be paying ~$5 billion for one year of treatment. That's one top of some other regular treatment (i.e. meds) that it does not appear to cover. That's roughly the budget of all the hospitals in Sydney
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Replying to @GidMK
In the US it can cost $1000 a month for Insulin alone, so its cost effective for them. You are also looking at a projected 1,000,000, how much is that going to cost to treat over decades? The virta treatment is not secret, you can do it yourself.
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Replying to @akmcintyre
I guess the point I'd make is that no one is arguing that spending many thousands of dollars a year on each individual with diabetes can be effective in making them lose weight/improve HbA1c, but to do so we'd either have to shut down hospitals or enormously increase health spend
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Replying to @GidMK @akmcintyre
It ~might~ be cost-effective, but probably only for people who are already quite sick. We're currently designing a similar intervention, but it's only going to be for people who meet fairly stringent eligibility criteria
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Replying to @GidMK
I find it hard to believe that reversing diabetes in 50% of the patients would be more expensive than supplying them with ongoing care and medications. The intervention in its basic form is not expensive at all.
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Replying to @akmcintyre
I mean, Virta is an extremely expensive private example, but even your generic intensive lifestyle modification intervention is pretty pricey - you need intensive, ongoing support for patients from multiple clinicians as well as a whole heap of devices
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For individual patients with high risk of complications? Certainly. For entire populations of people with diabetes? That's a much tougher sell, and far less likely to be cost-effective
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