Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic

Rathi Ravindrarajah; Matthew Gittins; Luke Paterson; Gabriel Rogers; George Tilson; Deborah J Wake; Doogie Brodie; Scott G Cunningham; Naresh Kanumilli; Ewan Jones; Peter Elton; Nicola Milne; Michael Morgan-Curran; Evangelos Kontopantelis; Thomas Allen; Martin K Rutter

doi:10.1371/journal.pone.0349232

Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic

Rathi Ravindrarajah (Lead / Corresponding author)
, Matthew Gittins
, Luke Paterson
, Gabriel Rogers
, George Tilson
, Deborah J Wake
, Doogie Brodie
, Scott G Cunningham
, Naresh Kanumilli
, Ewan Jones
, Peter Elton
, Nicola Milne
, Michael Morgan-Curran
, Evangelos Kontopantelis
, Thomas Allen
, Martin K Rutter

Diabetes Endocrinology and Reproductive Biology

Research output: Contribution to journal › Article › peer-review

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Abstract

AIMS: We aimed to assess a) whether using the digital intervention, MyWay Diabetes (MWD), during the COVID-19 pandemic in Greater Manchester was associated with improvements in glycaemia and cardiovascular risk factors; and b) the cost-effectiveness of MWD.

METHODS: From 01st July 2019-30th April 2022, we assessed risk factor changes in MWD users (n = 507) with T2D, adjusting for changes in a matched control group of non-users (n = 10,135). Economic evaluation was conducted using United Kingdom Prospective Diabetes Study Outcomes Model version 2.1 simulating 1,000 patients over 40-years based on observed risk factor changes.

RESULTS: Over 2-years follow-up, MWD use was associated with a clinically significant reductions in HbA1c of 3.1 (95%CI: 1.5 to 4.6) mmol/mol and decreases in systolic blood pressure (1.4 (0.2 to 2.6) mmHg) and cholesterol (0.1 (0.02 to 0.2) mmol/L) when compared to non-users. Including medication costs, MWD generated more health (0·015 QALYs) and lower costs (-£67 per person) compared to usual care. Excluding medication costs, MWD generated QALYs at a cost of £389 each, below the NICE threshold of £20,000-30,000/QALY.

INTERPRETATION: At population level, the risk factor changes associated with MWD are likely to reduce long-term diabetes-related complications risks and the intervention appears cost-effective.

Original language	English
Pages (from-to)	e0349232
Journal	PLoS ONE
Volume	21
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0349232
Publication status	Published - 25 Jun 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Humans
Diabetes Mellitus, Type 2/therapy
Cost-Benefit Analysis
Cost-Effectiveness Analysis
COVID-19/epidemiology
Female
Male
Middle Aged
Aged
United Kingdom/epidemiology
Glycated Hemoglobin/analysis
Digital Health
Pandemics
SARS-CoV-2/isolation & purification
Blood Glucose/analysis
Risk Factors

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10.1371/journal.pone.0349232Licence: CC BY

Final Published Version
Copyright: © 2026 Ravindrarajah et al. This is an open access article distributed under the terms of the Creative Commons Attribution
Final published version, 1.5 MBLicence: CC BY

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Ravindrarajah, R., Gittins, M., Paterson, L., Rogers, G., Tilson, G., Wake, D. J., Brodie, D., Cunningham, S. G., Kanumilli, N., Jones, E., Elton, P., Milne, N., Morgan-Curran, M., Kontopantelis, E., Allen, T., & Rutter, M. K. (2026). Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic. PLoS ONE, 21(6), e0349232. https://doi.org/10.1371/journal.pone.0349232

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title = "Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic",

abstract = "AIMS: We aimed to assess a) whether using the digital intervention, MyWay Diabetes (MWD), during the COVID-19 pandemic in Greater Manchester was associated with improvements in glycaemia and cardiovascular risk factors; and b) the cost-effectiveness of MWD.METHODS: From 01st July 2019-30th April 2022, we assessed risk factor changes in MWD users (n = 507) with T2D, adjusting for changes in a matched control group of non-users (n = 10,135). Economic evaluation was conducted using United Kingdom Prospective Diabetes Study Outcomes Model version 2.1 simulating 1,000 patients over 40-years based on observed risk factor changes.RESULTS: Over 2-years follow-up, MWD use was associated with a clinically significant reductions in HbA1c of 3.1 (95\%CI: 1.5 to 4.6) mmol/mol and decreases in systolic blood pressure (1.4 (0.2 to 2.6) mmHg) and cholesterol (0.1 (0.02 to 0.2) mmol/L) when compared to non-users. Including medication costs, MWD generated more health (0·015 QALYs) and lower costs (-£67 per person) compared to usual care. Excluding medication costs, MWD generated QALYs at a cost of £389 each, below the NICE threshold of £20,000-30,000/QALY.INTERPRETATION: At population level, the risk factor changes associated with MWD are likely to reduce long-term diabetes-related complications risks and the intervention appears cost-effective.",

keywords = "Humans, Diabetes Mellitus, Type 2/therapy, Cost-Benefit Analysis, Cost-Effectiveness Analysis, COVID-19/epidemiology, Female, Male, Middle Aged, Aged, United Kingdom/epidemiology, Glycated Hemoglobin/analysis, Digital Health, Pandemics, SARS-CoV-2/isolation \& purification, Blood Glucose/analysis, Risk Factors",

author = "Rathi Ravindrarajah and Matthew Gittins and Luke Paterson and Gabriel Rogers and George Tilson and Wake, \{Deborah J\} and Doogie Brodie and Cunningham, \{Scott G\} and Naresh Kanumilli and Ewan Jones and Peter Elton and Nicola Milne and Michael Morgan-Curran and Evangelos Kontopantelis and Thomas Allen and Rutter, \{Martin K\}",

note = "Copyright: {\textcopyright} 2026 Ravindrarajah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2026",

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Ravindrarajah, R, Gittins, M, Paterson, L, Rogers, G, Tilson, G, Wake, DJ, Brodie, D, Cunningham, SG, Kanumilli, N, Jones, E, Elton, P, Milne, N, Morgan-Curran, M, Kontopantelis, E, Allen, T & Rutter, MK 2026, 'Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic', PLoS ONE, vol. 21, no. 6, pp. e0349232. https://doi.org/10.1371/journal.pone.0349232

Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic. / Ravindrarajah, Rathi (Lead / Corresponding author); Gittins, Matthew; Paterson, Luke et al.
In: PLoS ONE, Vol. 21, No. 6, 25.06.2026, p. e0349232.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic

AU - Ravindrarajah, Rathi

AU - Gittins, Matthew

AU - Paterson, Luke

AU - Rogers, Gabriel

AU - Tilson, George

AU - Wake, Deborah J

AU - Brodie, Doogie

AU - Cunningham, Scott G

AU - Kanumilli, Naresh

AU - Jones, Ewan

AU - Elton, Peter

AU - Milne, Nicola

AU - Morgan-Curran, Michael

AU - Kontopantelis, Evangelos

AU - Allen, Thomas

AU - Rutter, Martin K

N1 - Copyright: © 2026 Ravindrarajah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2026/6/25

Y1 - 2026/6/25

N2 - AIMS: We aimed to assess a) whether using the digital intervention, MyWay Diabetes (MWD), during the COVID-19 pandemic in Greater Manchester was associated with improvements in glycaemia and cardiovascular risk factors; and b) the cost-effectiveness of MWD.METHODS: From 01st July 2019-30th April 2022, we assessed risk factor changes in MWD users (n = 507) with T2D, adjusting for changes in a matched control group of non-users (n = 10,135). Economic evaluation was conducted using United Kingdom Prospective Diabetes Study Outcomes Model version 2.1 simulating 1,000 patients over 40-years based on observed risk factor changes.RESULTS: Over 2-years follow-up, MWD use was associated with a clinically significant reductions in HbA1c of 3.1 (95%CI: 1.5 to 4.6) mmol/mol and decreases in systolic blood pressure (1.4 (0.2 to 2.6) mmHg) and cholesterol (0.1 (0.02 to 0.2) mmol/L) when compared to non-users. Including medication costs, MWD generated more health (0·015 QALYs) and lower costs (-£67 per person) compared to usual care. Excluding medication costs, MWD generated QALYs at a cost of £389 each, below the NICE threshold of £20,000-30,000/QALY.INTERPRETATION: At population level, the risk factor changes associated with MWD are likely to reduce long-term diabetes-related complications risks and the intervention appears cost-effective.

AB - AIMS: We aimed to assess a) whether using the digital intervention, MyWay Diabetes (MWD), during the COVID-19 pandemic in Greater Manchester was associated with improvements in glycaemia and cardiovascular risk factors; and b) the cost-effectiveness of MWD.METHODS: From 01st July 2019-30th April 2022, we assessed risk factor changes in MWD users (n = 507) with T2D, adjusting for changes in a matched control group of non-users (n = 10,135). Economic evaluation was conducted using United Kingdom Prospective Diabetes Study Outcomes Model version 2.1 simulating 1,000 patients over 40-years based on observed risk factor changes.RESULTS: Over 2-years follow-up, MWD use was associated with a clinically significant reductions in HbA1c of 3.1 (95%CI: 1.5 to 4.6) mmol/mol and decreases in systolic blood pressure (1.4 (0.2 to 2.6) mmHg) and cholesterol (0.1 (0.02 to 0.2) mmol/L) when compared to non-users. Including medication costs, MWD generated more health (0·015 QALYs) and lower costs (-£67 per person) compared to usual care. Excluding medication costs, MWD generated QALYs at a cost of £389 each, below the NICE threshold of £20,000-30,000/QALY.INTERPRETATION: At population level, the risk factor changes associated with MWD are likely to reduce long-term diabetes-related complications risks and the intervention appears cost-effective.

KW - Humans

KW - Diabetes Mellitus, Type 2/therapy

KW - Cost-Benefit Analysis

KW - Cost-Effectiveness Analysis

KW - COVID-19/epidemiology

KW - Female

KW - Male

KW - Middle Aged

KW - Aged

KW - United Kingdom/epidemiology

KW - Glycated Hemoglobin/analysis

KW - Digital Health

KW - Pandemics

KW - SARS-CoV-2/isolation & purification

KW - Blood Glucose/analysis

KW - Risk Factors

U2 - 10.1371/journal.pone.0349232

DO - 10.1371/journal.pone.0349232

M3 - Article

C2 - 42348536

SN - 1932-6203

VL - 21

SP - e0349232

JO - PLoS ONE

JF - PLoS ONE

IS - 6

ER -

Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic

Abstract

UN SDGs

Keywords

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