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.