Abstract: This thesis addressed the growing challenge of diabetes by exploring the cost-effectiveness of precision medicine interventions. Diabetes varies greatly among individuals, making precision treatments crucial for improving outcomes and reducing healthcare system burdens. The research encompassed a scoping review of precision medicine studies, an evaluation of a personalized diabetic retinopathy screening and a predictive model for diabetic foot ulcers, an assessment of a diabetes health economic model's transferability and a cost-effectiveness analysis of a glucose monitoring device for specific type 1 diabetes subgroups. Key findings highlighted a shortage of cost-effectiveness data in precision medicine for diabetes. Challenges included insufficient long-term efficacy and safety data, as well as missing essential biomarkers in practical use. Nonetheless, personalized diabetic retinopathy screening emerged as a cost-effective alternative while the prediction model for diabetic foot ulcers yielded mixed results compared to Dutch guidelines. Transferability of the health economic model showed variability among cohorts and outcomes, emphasizing the importance of model validation when applied to new populations. For glucose monitoring devices, cost-effectiveness was contingent on factors, with the highest probability observed in select subgroups. In summary, while precision medicine is increasingly adopted in diabetes management, its cost-effectiveness remains uncertain. This thesis contributes insights, indicating that personalized approaches for diabetic retinopathy and specific glucose monitoring devices can offer cost-effective solutions. However, improvements may be needed to enhance the cost-effectiveness of personalized diabetic foot ulcer referrals. This research underscores the significance of tailored diabetes care, identifying areas where precision medicine can deliver health benefits and cost savings.
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