Cost-Effectiveness Analysis of Point-Of-Care A1c Tests in the Primary Care Setting of Iran Publisher Pubmed



Mousavi A ; Raadabadi M ; Darvishi A
Source: Expert Review of Pharmacoeconomics and Outcomes Research Published:2026

Abstract

Background: Given the critical role of timely monitoring in diabetes management, effective and accessible testing strategies are increasingly vital. This study evaluated the cost-effectiveness of point-of-care A1c (POC-A1c) testing compared with traditional laboratory-based A1c testing in primary care settings in Iran. Research design and methods: A lifetime (40 year) Markov model was developed to estimate expected costs (valued in 2023 PPP-adjusted US dollars), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) for the two strategies. Deterministic and probabilistic sensitivity analyses were performed to assess uncertainty in key model parameters. Results: POC-A1C was associated with an incremental cost of US$1,647.76 and a 0.15 QALY gain versus traditional laboratory testing, yielding an ICER of US$10,717.27 per QALY. Consequently, it was cost-effective at a willingness-to-pay threshold equal to Iran’s 2023 per capita GDP. Also, based on probabilistic sensitivity analysis, the probability of POC-A1C being cost-effective was 58%. Conclusions: These findings suggest that integrating POC-A1c testing into primary care may represent a valuable strategy for strengthening diabetes management in Iran. While associated with higher direct costs, its potential to improve glycemic control and long-term health outcomes supports consideration by policymakers, particularly in the context of expanding access to timely diabetes monitoring. © 2026 Informa UK Limited, trading as Taylor & Francis Group.