An evaluation of cost sharing to finance a diet and physical activity intervention to prevent diabetes

Ronald T. Ackermann, David Marrero, Katherine A. Hicks, Thomas J. Hoerger, Stephen Sorensen, Ping Zhang, Michael M. Engelgau, Robert E. Ratner, William H. Herman

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

OBJECTIVE - The Diabetes Prevention Program (DPP) lifestyle intervention is a costeffective strategy to prevent type 2 diabetes, but it is unclear how this intervention could be financed. We explored whether this intervention could be offered in a way that allows return on investment for private health insurers while remaining attractive for consumers, employers, and Medicare. RESEARCH DESIGN AND METHODS - We used the DPP and other published reports to build a Markov simulation model to estimate the lifetime progression of disease, costs, and quality of life for adults with impaired glucose tolerance. The model assumed a health-payer perspective and compared DPP lifestyle and placebo interventions. Primary outcomes included cumulative incidence of diabetes, direct medical costs, quality-adjusted life-years (QALYs), and cost per QALY gained. RESULTS - Compared with placebo, providing the lifestyle intervention at age 50 years could prevent 37% of new cases of diabetes before age 65, at a cost of $1,288 per QALY gained. A private payer could reimburse $655 (24%) of the $2,715 in total discounted intervention costs during the first 3 intervention years and still recover all of these costs in the form of medical costs avoided. If Medicare paid up to $2,136 in intervention costs over the 15-year period before participants reached age 65, it could recover those costs in the form of future medical costs avoided beginning at age 65. CONCLUSIONS - Cost-sharing strategies to offer the DPP lifestyle intervention for eligible people between ages 50 and 64 could provide financial return on investment for private payers and long-term benefits for Medicare.

Original languageEnglish
Pages (from-to)1237-1241
Number of pages5
JournalDiabetes Care
Volume29
Issue number6
DOIs
StatePublished - 2006

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Cost Sharing
Diet
Costs and Cost Analysis
Quality-Adjusted Life Years
Life Style
Medicare
Placebos
Insurance Carriers
Cost of Illness
Glucose Intolerance
Health
Type 2 Diabetes Mellitus
Research Design
Quality of Life

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Ackermann, R. T., Marrero, D., Hicks, K. A., Hoerger, T. J., Sorensen, S., Zhang, P., ... Herman, W. H. (2006). An evaluation of cost sharing to finance a diet and physical activity intervention to prevent diabetes. Diabetes Care, 29(6), 1237-1241. https://doi.org/10.2337/dc05-1709

An evaluation of cost sharing to finance a diet and physical activity intervention to prevent diabetes. / Ackermann, Ronald T.; Marrero, David; Hicks, Katherine A.; Hoerger, Thomas J.; Sorensen, Stephen; Zhang, Ping; Engelgau, Michael M.; Ratner, Robert E.; Herman, William H.

In: Diabetes Care, Vol. 29, No. 6, 2006, p. 1237-1241.

Research output: Contribution to journalArticle

Ackermann, RT, Marrero, D, Hicks, KA, Hoerger, TJ, Sorensen, S, Zhang, P, Engelgau, MM, Ratner, RE & Herman, WH 2006, 'An evaluation of cost sharing to finance a diet and physical activity intervention to prevent diabetes', Diabetes Care, vol. 29, no. 6, pp. 1237-1241. https://doi.org/10.2337/dc05-1709
Ackermann, Ronald T. ; Marrero, David ; Hicks, Katherine A. ; Hoerger, Thomas J. ; Sorensen, Stephen ; Zhang, Ping ; Engelgau, Michael M. ; Ratner, Robert E. ; Herman, William H. / An evaluation of cost sharing to finance a diet and physical activity intervention to prevent diabetes. In: Diabetes Care. 2006 ; Vol. 29, No. 6. pp. 1237-1241.
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