Return on Investment for Digital Behavioral Counseling in Patients With Prediabetes and Cardiovascular Disease
Open accessAbstract
INTRODUCTION: We calculated the health and economic impacts of participation in a digital behavioral counseling service that is designed to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with prediabetes and cardiovascular disease risk factors (Prevent, Omada Health, San Francisco, California). This program enhances the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. Participants completed a 16-week core program followed by an ongoing maintenance program. METHODS: Analysis was conducted for 2 populations meeting criteria for lifestyle intervention: 1) prediabetes (n = 1,663), and 2) high cardiovascular disease risk (n = 2,152). The Markov-based model simulated clinical and economic outcomes related to obesity and diabetes annually over 10 years for the 2 defined populations. Comparisons were made between participants and propensity-matched controls from the community. RESULTS: The return-on-investment break-even point was 3 years in both populations. Simulated return on investment for the population with prediabetes was $9 and $1,565 at years 3 and 5, respectively. Simulated return on investment for the population with cardiovascular disease risk was $96 and $1,512 at years 3 and 5, respectively. Results suggest that program participation reduces diabetes incidence by 30% to 33% and stroke by 11% to 16% over 5 years. CONCLUSION: Digital Behavioral Counseling provides significant health benefits to patients with prediabetes and cardiovascular disease and a positive return on investment.
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Among a general adult population, estimates of medical savings per person from this digital IBC exceeded $1,300 within three years, and benefits continued growing to $8,000-$9,000 cumulative over 10 years.
“Among a general adult population, estimates of medical savings per person exceeded $1,300 within three years, and benefits continued growing to $8,000-$9,000 cumulative over 10 years [14].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [14]
The Discussion reports simulated per-person medical savings of $1,310 at three years and $9,217 at ten years for the program results, and $1,396 and $7,951 for the broader USPSTF-eligible group. But the Methods (Model population) limit the analyses to people with prediabetes or overweight/obesity, including those with cardiovascular risk factors; the estimates are not for the general adult population. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPrevious work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity.
“Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity (in the form of higher labor force participation and lower work absenteeism) [1–6,13–15,19].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [14]
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Experimental — accuracy not yet measuredIn this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.
“In this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [14]
The Methods (Simulation modeling; page not provided) describe a previously published, validated microsimulation model, and the Results report simulated reductions in cardiovascular events and medical expenditures. The claim's restriction to senior participants is not supported: the studied cohorts averaged about 49 years of age, with no senior-specific results reported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA digital, remotely-delivered IBC program that is an enhanced version of the original NDPP demonstrated clinical efficacy.
“A digital, remotely-delivered IBC program that is an enhanced version of the original NDPP demonstrated clinical efficacy [13–16].”
The digital IBC program exceeds the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program standards.
“The program exceeds the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program standards and eliminates the need for patients to travel to a “brick and mortar” program [14,17].”
The digital IBC program eliminates the need for patients to travel to a "brick and mortar" program.
“The program exceeds the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program standards and eliminates the need for patients to travel to a “brick and mortar” program [14,17].”
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- Authors
- Su, W., Chen, F., Dall, T. M., Iacobucci, W., & Perreault, L.
- Affiliations
- University of Colorado Anschutz (US)
- Corresponding author
- Su, Wenqing
- Venue
- Preventing Chronic Disease
- Published
- 2016-01-28
- Volume
- 13
- Pages
- E13-E13
- ISSN
- 1545-1151 (ISSN-L)
- PMC
- PMC4747438
- OpenAlex
- W2261715126
- Cited by
- 35
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 8 · 2017: 5 · 2016: 1
- FWCI
- 10.38
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- public-domain
- Locations
- Preventing Chronic Disease (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- prediabetes, cardiovascular disease, return on investment, lifestyle intervention, diabetes prevention, Markov model, economic evaluation, diabetes incidence, stroke, obesity, healthy eating, physical activity
- MeSH terms
- Cardiovascular Diseases, Computer Simulation, Female, Humans, Male, Middle Aged, Models, Theoretical, Prediabetic State, Weight Loss
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