National Diabetes Prevention Program enrollment may save on medical costs
Key takeaways:
- Enrollees had higher cost savings compared with non-enrollees.
- The greatest cost savings were for hospitalizations, outpatient visits and ED visits.
Enrollment in the CDC’s National Diabetes Prevention Program may provide direct medical cost savings for adults with prediabetes, according to analyses published in Diabetes Care.
“Previous cost-effectiveness evaluations often were conducted as a part of clinical trials or using simulation modeling of clinical trial results,” Shih-Chen Kuo, MS, BSPharm, PhD, associate research scientist in the division of metabolism, endocrinology and diabetes in the department of internal medicine at the University of Michigan Ann Arbor, and colleagues wrote. “There is limited information on the cost-effectiveness of the National Diabetes Prevention Program in real-world settings.”
Kuo and colleagues conducted difference-in-differences analyses using individual-level health insurance claims and survey data from 5,948 adults with prediabetes enrolled (n = 575) or not enrolled (n = 5,373) in the National Diabetes Prevention Program (NDPP). Researchers evaluated the effect of NDPP on health economic outcomes and direct medical costs for the year before and 2 years after enrollment.
NDPP enrollees were older (mean age, 53.8 years vs. 50.9 years), more likely to be women (73.6% vs. 54.9%) and were less likely to be white (77.3% vs. 80.2%) compared with non-enrollees.
Researchers observed an average reduction of $5,549 in 2-year total direct medical costs among each NDPP enrollee compared with costs in the year prior to enrollment. Each NDPP enrollee saved an average of $4,554 in 2-year total discounted direct medical costs compared with non-enrollees. Cost savings ranged from $3,393 for hospitalization to $10 for laboratory testing. Most lower costs were attributed to lower hospitalization, outpatient visit and ED visit costs.
There were minimal differences between enrollees and non-enrollees in EuroQol-5D-5L questionnaire utility scores at 2 years or quality-adjusted life-years gained over 2 years. However, enrollees were less likely to develop diabetes at 2 years compared with non-enrollees (5.09% vs. 7.85%; absolute risk reduction, 2.77 percentage points; number needed to treat with NDPP to prevent one case of diabetes every 2 years = 36).
In uncertainty analyses, researchers observed an 88% probability of cost savings and an 84% probability of cost-effectiveness at a willingness-to-pay threshold of $100,000 per QALYs gained over 2 years among NDPP enrollees.
“Our results suggest that the NDPP enrollees, compared with non-enrollees, are likely to save direct medical costs over 2 years. If delivered to a larger prediabetes population with longer-term follow-up, the NDPP could potentially reduce health care costs and improve QALYs for millions of American adults with prediabetes,” the researchers wrote. “Further research is warranted to confirm our findings and their generalizability to other populations and settings.”
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