Cost-effectiveness analysis of the Neuropad device as a screening tool for early diabetic peripheral neuropathy

  • B. Rodríguez-SánchezEmail author
  • L. M. Peña-Longobardo
  • A. J. Sinclair
Original Paper



To carry out a cost-effectiveness analysis of the use of Neuropad as a screening test for diabetic neuropathy together with the standard care tool, the 10-g monofilament, in people with diabetes.

Research design and methods

A cost-effectiveness analysis using a Markov model was developed to assess the impact on costs and outcomes of using Neuropad as a test for diabetic neuropathy (1) as a complement to the standard test, the 10-g monofilament (Neuropad + monofilament vs. monofilament); and (2) as a substitute for the monofilament (Neuropad vs. monofilament); from the healthcare provider perspective. The time horizon was 3 years. Data on costs and health gains were extracted from the literature. The incremental cost–utility ratio was calculated. Deterministic and probabilistic sensitivity analyses were also performed.


Compared with standard care, Neuropad, in combination with the 10-g monofilament tool, is the dominant strategy as it leads to higher health gains and lower costs. In practice, compared with using the monofilament alone, performing both tests would lead to a savings of £1049.26 per patient and 0.044 QALY gain. Results were found to be consistent across the sensitivity analyses.


Using both screening tools (Neuropad + monofilament) is a cost-effective strategy and the dominant alternative, when compared against using the 10-g monofilament alone. The results would be of special relevance in the early detection of diabetic peripheral neuropathy and to ensure the efficient allocation of resources and, thus, the sustainability of healthcare systems.


Neuropad Diabetes Diabetic peripheral neuropathy Cost-effectiveness SWME 

JEL Classification

H00 H5 H51 I00 I1 I10 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We thank the contribution of John Simpson, Peter Altman and Marta Trapero Bertrán, as well as the anonymous referees that have reviewed different versions of this manuscript for their appreciated input to this research paper.

Compliance with ethical standards

Conflicts of interest

No potential conflicts of interest relevant to this article were reported.

Supplementary material

10198_2019_1134_MOESM1_ESM.docx (58 kb)
Supplementary material 1 (DOCX 57 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Law and Social SciencesUniversity of Castilla-La ManchaToledoSpain
  2. 2.Foundation for Diabetes Research in Older People, Diabetes Frail LtdUniversity of AstonBirminghamUK

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