Cost of a Group Translation of the Diabetes Prevention Program

Abstract

Background Although numerous studies have translated the Diabetes Prevention Program lifestyle intervention into various settings, no study to date has reported a formal cost analysis. Purpose To describe costs associated with the Healthy Living Partnerships to Prevent Diabetes (HELP PD) trial. Design HELP PD was a 24-month RCT testing the impact of a lifestyle weight-loss intervention administered through a diabetes education program and delivered by community health workers (CHWs) on blood glucose and body weight among prediabetics. Setting/participants In all, 301 participants with prediabetes were randomized in Forsyth County NC. Data reported in these analyses were collected in 2007–2011 and analyzed in 2011–2012. Intervention The lifestyle weight-loss group had a 7% weight loss goal achieved and maintained by caloric restriction and increased physical activity. The usual care group received two visits with a registered dietitian and monthly newsletters. Main outcome measures Measures are direct medical costs, direct nonmedical costs and indirect costs over the 2-year study period. Research costs are excluded. Results The direct medical cost (in 2010 dollars) to identify one participant was $16.85. Direct medical costs per capita for participants in the usual care group were $142 and $850 for lifestyle weight-loss participants. Per capita direct costs of care outside the study were $7454 for the usual care group and $5177 for the lifestyle weight-loss group. Per capita direct nonmedical costs were $12,881 for the usual care group and $13,836 for the lifestyle weight-loss group. The lifestyle weight-loss group in HELP PD cost $850 in direct medical costs for 2 years, compared to $2631 in direct medical costs for the first 2 years of DPP. Conclusions A community-based translation of the DPP can be delivered effectively and with reduced costs.

The healthy living partnerships to prevent diabetes and the diabetes prevention program: a comparison of year 1 and 2 intervention results

“…All participants signed informed consent and the Institutional Review Board of Wake Forest University Health Sciences approved the trial. Details regarding the HELP PD trial design, participant recruitment, outcomes, and cost have been published elsewhere [9,10,14,15,[22][23][24]. For the purpose of this evaluation, only data from participants in the lifestyle intervention arm is included.…”

Comment on Kahn and Davidson. The Reality of Type 2 Diabetes Prevention. Diabetes Care 2014;37:943–949

“…Kahn and Davidson omitted an economic analysis of the Healthy Living Partnerships to Prevent Diabetes (HELP PD) study (2). That analysis provided evidence that the DPP intervention can be delivered by lay community health workers in a group setting for approximately $850 per person over the first 2 years (2).…”

Capsule Commentary on Ritzwoller et al., Economic Analyses of the Be Fit Be Well Program: A Weight Loss Program for Community Health Centers

“…Previous studies have suggested weight-loss programs reduce medical care costs outside interventions. 2,4 If this was also true in this study and the reduction in the medical care costs had been accounted, the program might be more cost-effective. Third, a significant proportion of participants did not complete study assessments.…”

“…1 The program was estimated to cost $2,204 per kg loss per person, which is somewhat higher than that of similar studies. [2][3][4] For primary care clinics, this study provided a good example of the economic resources needed for delivering a weight-loss program to "a low literacy, inner city" population. A detailed description of their program costs will inform primary care providers of the expected budget impact, as well as potential areas for improving program efficiency.…”