Lifestyle-change Diabetes Prevention Programs cost more than participants are willing to pay; new funding needed for program expansion

Study estimates cost sharing of Diabetes Prevention Programs among participants and public health agencies to find approaches for scaling up programs

RESEARCH TRIANGLE PARK, NC— More than 86 million Americans have prediabetes. Diabetes Prevention Programs teach people with prediabetes how to make lifestyle changes (increase physical activity, eat healthier and lose weight) to help delay or prevent type 2 diabetes. But, use of such programs is not yet widespread.

A new study by researchers from RTI International and the University of North Carolina at Chapel Hill examined willingness to pay for these programs under three scenarios and found that North Carolinians were willing to pay $39 a month if the program was led by a registered professional, such as a nurse, doctor, dietician or pharmacist, $31 if led by a community health worker, and $19 if administered online.

However, the cost of providing these programs in North Carolina and across all three scenarios is higher than people’s willingness to pay. The average minimum price per person per month for a local health department or community health center to offer the programs was $79 if led by a registered professional, $49 if led by a community health worker, and $57 if administered online.

“To make Diabetes Prevention Programs viable and widely available, it’s important to understand how willing a person is to pay for these services relative to the cost of delivering the program,” said Maria Alva, health economist at RTI International and co-author of the study. “Given the wide gap in program cost and willingness to pay by participants, it’s clear that expanding these programs will require new sources of funding.”

The largest influence in determining an individual’s willingness to pay was socioeconomic status, measured by education and employment.

The study matches supply and demand estimates to determine the degree of cost sharing between recipients and providers and the extent of likely market coverage of alternate approaches to scaling up and sustaining diabetes prevention programs with available resources and in the presence of subsidies.

“The ideal subsidy for these programs should be set at the breakeven point where savings from the program, such as a reduction in health care use, offset program costs,” Alva said. “This will help ensure that people get the help they need to prevent or delay type 2 diabetes and that program is financially stable.”