Cost‐Effectiveness of a Community‐Based Diabetes Prevention Program with Participation Incentives for Medicaid Beneficiaries. (16th May 2018)

• Record Type: Journal Article
• Authors: Gilmer, Todd; O'Connor, Patrick J.; Schiff, Jeffrey S.; Taylor, Gretchen; Vazquez‐Benitez, Gabriela; Garrett, Joyce E.; Vue‐Her, Houa; Rinn, Sarah; Anderson, Julie; Desai, Jay
• Is Part Of: Health services research. Volume 53:Number 6(2018)
• Page Start: 4704
• Page End: 4724
• Publication Date: 2018-05-16
• Subjects: Cost‐effectiveness -- Medicaid -- health care costs; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12973
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract : Objective: To examine the cost‐effectiveness of a community‐based Diabetes Prevention Program (DPP) for Medicaid beneficiaries from the perspective of the health care sector. Data Sources/Study Setting: A total of 847 Medicaid enrollees at high risk for type 2 diabetes participating in a community‐based DPP. Study Design: Pre‐ and post clinical outcome and cost data were used as inputs into a validated diabetes simulation model. The model was used to evaluate quality‐adjusted life years (QALYs) and health care costs over a 40‐year time horizon from the perspective of the health care sector. Data Collection/Extraction Methods: Clinical outcome and cost data were derived from a study examining the effect of financial incentives on weight loss. Principal Findings: Study participants lost an average of 4.2 lb ( p < .001) and increased high‐density lipoprotein cholesterol by 1.75 mg/dl ( p = .002). Intervention costs, which included financial incentives for participation and weight loss, were $915 per participant. The incremental cost‐effectiveness ratio was estimated to be $14, 011 per QALY but was sensitive to the time horizon studied. Conclusions: Widespread adoption of community‐based DPP has the potential to reduce diabetes and cardiovascular‐related morbidity and mortality for low‐income persons at high risk for diabetes and may be a cost‐effective investment for Medicaid programs.