Cost-effectiveness of the national diabetes prevention program: a real-world, 2-Year prospective study
Open accessAbstract
OBJECTIVE: We evaluated the real-world cost-effectiveness of the National Diabetes Prevention Program (NDPP) for people with prediabetes in a large workforce with employer-sponsored health insurance. RESEARCH DESIGN AND METHODS: We performed difference-in-differences analyses using individual-level health insurance claims and survey data for 5,948 adults with prediabetes who enrolled (n = 575) or did not enroll (n = 5,373) in the NDPP to assess NDPP’s effects on health economic outcomes. We assessed direct medical costs for the year before the NDPP enrollment/index date and for 2 years thereafter; EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) utility scores at baseline, 1 year, and 2 years; and quality-adjusted life-years (QALYs) over 2 years. We used propensity score weighting to adjust for potential bias due to self-selection for enrollment, multiple imputation to handle missing data, and bootstrapping to produce CIs. We adopted a health care sector perspective and discounted costs and QALYs at 3% annually. Costs were expressed in 2020 U.S. dollars. RESULTS: Compared with nonenrollees, each NDPP enrollee had an average reduction of $4,552 (95% CI −13,231, 2,014) in 2-year total direct medical costs. Cost savings were primarily related to hospitalizations, outpatient visits, and emergency room visits. Compared with nonenrollees, each enrollee had no difference in EQ-5D-5L utility scores at 2 years or QALYs gained over 2 years. The uncertainty analyses found that enrollment in the NDPP had an 88% probability of saving money and 84% probability of being cost-effective at a willingness-to-pay threshold of $100,000 per QALY gained over 2 years. CONCLUSIONS: In this real-world population with prediabetes, enrollment in the NDPP was likely to provide cost savings.
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Structured lifestyle interventions based on the Diabetes Prevention Program have demonstrated favorable economic profiles in real-world settings, with a high probability of cost-effectiveness and potential cost savings over time.
“Structured lifestyle interventions based on models such as the Diabetes Prevention Program have demonstrated favorable economic profiles in real-world settings, with evidence suggesting a high probability of cost-effectiveness and potential cost savings over time.102”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [102]
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- Authors
- Kuo, S., Ye, W., Wang, D., McEwen, L. N., Villatoro Santos, C., & Herman, W. H.
- Affiliations
- University of Michigan (US)
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan 1 , Ann Arbor, MI
- Corresponding author
- Kuo, Shihchen
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2024-11-20
- Volume
- 48
- Issue
- 7
- Pages
- 1180-1188
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC12178621
- OpenAlex
- W4404562426
- Cited by
- 19
- References
- 44
- Citations by year
- 2026: 12 · 2025: 7
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092926, R01DK109995)
- Centers for Disease Control and Prevention (U18DP006712)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- National Diabetes Prevention Program, prediabetes, cost-effectiveness, diabetes prevention, employer-sponsored health insurance, direct medical costs, quality-adjusted life years, hospitalization, workplace health promotion
- MeSH terms
- Adult, Aged, Cost-Benefit Analysis, Diabetes Mellitus, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Prediabetic State, Prospective Studies, Quality-Adjusted Life Years
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