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Study Finds a Diabetes Prevention Program Could Save $5.7 Billion in 25 Years

RESEARCH TRIANGLE PARK, N.C. — A community-based lifestyle intervention program could prevent nearly 885,000 cases of type 2 diabetes and save $5.7 billion over the next 25 years, according to a study by researchers at the Centers for Disease Control and Prevention and RTI International.

The study was published in the January issue of Health Affairs. According to the authors, diabetes accounted for one-tenth of U.S. health care expenditures in 2007, and the number of people in the U.S. with diabetes is projected to nearly double by 2034 to 44 million, with health care spending attributable to diabetes nearly tripling to $336 billion.

"To prevent human suffering and reduce health care costs, policy makers have called for additional efforts to prevent type 2 diabetes," said Tom Hoerger, Ph.D., director of the Public Health Economics Program at RTI International. "The National Diabetes Prevention Program is establishing a national prevention program for people at risk of developing diabetes, but there is concern about the cost of such wide implementation of a program. Our study found that the program would create long-term cost savings."

To conduct the study, the researchers examined a hypothetical prevention strategy consisting of a screening to identify a target population for an evidence-based lifestyle intervention to project the costs and outcomes of such a program. The hypothetical intervention program screened adults ages 18 to 84, and those at a high risk for developing type 2 diabetes would be eligible for the lifestyle intervention.

The researchers used a type 2 diabetes simulation model developed by the CDC and RTI to estimate the 25-year health care and economic outcomes of implementing a community-wide diabetes prevention program.

In the hypothetical intervention program, nearly 100 million Americans ages 18 to 84 would be screened over the next 25 years and nearly 23 million of those would have pre-diabetes. Another 13 million would be expected to be enrolled in a lifestyle intervention.

The researchers projected that over the 25-year simulation period the hypothetical program would prevent or delay 885,000 new cases of type 2 diabetes and result in a gain of 952,000 life-years and 669,000 quality-adjusted life-years.

The researchers projected that the program would cost $24.1 billion for screening, diagnosis and lifestyle intervention; however, the program would result in $29.8 billion in downstream savings from treatment costs for those who may have developed diabetes and diabetes-related complications without intervention.

According to the researchers, that would lead to a net savings of $5.7 billion for the intervention program over twenty-five years.

For those people ages 65 to 84, the program could cost $1.2 billion ($300 million for screening costs and $900 million for lifestyle modification programs) the first year, with increasing net costs until year three, after which it would start to decline. The projected cost savings would increase to $2.4 billion by year 25 for that age group.

However, the authors noted that for the cost savings to be reached, a long-term budget horizon is required and the initial implementation of the program would require a large amount of financial resources.

"Our results show that implementing a nationwide screening and community-based lifestyle intervention for preventing type 2 diabetes would not only improve health but would also reduce health care costs over the long term," Hoerger said. "Thus, implementing such a community-based lifestyle intervention program nationwide would be an efficient use of health care resources."