Cost-effectiveness of the National Diabetes Prevention Program: A Real-world, 2-Year Prospective Study
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: We evaluated the real-world cost-effectiveness of the National Diabetes Prevention Program (NDPP) for people with prediabetes in a large workforce with employer-sponsored health insurance. RESEARCH DESIGN AND METHODS: We performed difference-in-differences analyses using individual-level health insurance claims and survey data for 5,948 adults with prediabetes who enrolled (n = 575) or did not enroll (n = 5,373) in the NDPP to assess NDPP's effects on health economic outcomes. We assessed direct medical costs for the year before the NDPP enrollment/index date and for 2 years thereafter; EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) utility scores at baseline, 1 year, and 2 years; and quality-adjusted life-years (QALYs) over 2 years. We used propensity score weighting to adjust for potential bias due to self-selection for enrollment, multiple imputation to handle missing data, and bootstrapping to produce CIs. We adopted a health care sector perspective and discounted costs and QALYs at 3% annually. Costs were expressed in 2020 U.S. dollars. RESULTS: Compared with nonenrollees, each NDPP enrollee had an average reduction of $4,552 (95% CI -13,231, 2,014) in 2-year total direct medical costs. Cost savings were primarily related to hospitalizations, outpatient visits, and emergency room visits. Compared with nonenrollees, each enrollee had no difference in EQ-5D-5L utility scores at 2 years or QALYs gained over 2 years. The uncertainty analyses found that enrollment in the NDPP had an 88% probability of saving money and 84% probability of being cost-effective at a willingness-to-pay threshold of $100,000 per QALY gained over 2 years. CONCLUSIONS: In this real-world population with prediabetes, enrollment in the NDPP was likely to provide cost savings.
Source: Diabetes Care
DOI: 10.2337/dc24-1110
Authors: Shihchen Kuo, Wen Ye, Di Wang, Laura N. McEwen, Claudia Villatoro Santos, William H. Herman
Institutions: University of Michigan, Michigan Medicine
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: bronze
Awards: G183749437, G301048564, REAL-WORLD EFFECTIVENESS OF STRUCTURED LIFESTYLE INTERVENTIONS IN PREVENTING TYPE 2 DIABETES, Population Health Impact of a Self-Insured Employer's Policy Change to Cover Weight Reduction and Diabetes Prevention Interventions for Employees, Dependents, and Retirees with Prediabetes, Michigan Center for Diabetes Translational Research, Michigan Diabetes Research Center (MDRC)
OpenAlex ID: W4404562426