Selecting a target population for type 2 diabetes lifestyle prevention programs: A cost-effectiveness perspective

Details

• Alternative Title:
  Diabet Med
• Personal Author:
  Park, Joohyun ; Zhang, Ping ; Shao, Hui ; Laxy, Michael ; Imperatore, Giuseppina
• Description:
  Aims:
  
  Cost-effectiveness (CE) of lifestyle change programs (LCP) for type 2 diabetes (T2D) prevention is influenced by a participant’s risk. We identified the risk threshold of developing T2D in the intervention population that was cost-effective for three formats of the LCP: delivered in-person individually or in groups, or delivered virtually. We compared the cost-effectiveness across program formats when there were more than one cost-effective formats.
  
  Methods:
  
  Using the CDC-RTI T2D CE Simulation model, we estimated CEs associated with 3 program formats in 8 population groups with an annual T2D incidence of 1% to 8%. We generated a nationally representative simulation population for each risk level using the 2011–2016 National Health and Nutrition Examination Survey data. We used an incremental cost-effectiveness ratio (ICER), cost per quality-adjusted life year (QALY) gained in 25-years, to measure the CEs of the programs. We took a health care system perspective.
  
  Results:
  
  To achieve an ICER of $50,000/QALY or lower, the annual T2D incidence of the program participant needed to be ≥5% for the in-person individual program, ≥4% for the digital individual program, and ≥3% for the in-person group program. For those with T2D risk of ≥4%, the in-person group program always dominated the digital individual program. The in-person individual program was cost-effective compared with the in-person group program only among persons with T2D risk of ≥8%.
  
  Conclusions:
  
  Our findings could assist decision-makers in selecting the most appropriate target population for different formats of lifestyle intervention programs to prevent T2D.
  
  
• Subjects:
  Article Cost-Benefit Analysis Cost-effectiveness Diabetes Mellitus, Type 2 Humans Life Style Lifestyle Change Program Nutrition Surveys Prevention Quality-Adjusted Life Years Type 2 Diabetes

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• Source:
  Diabet Med. 39(7):e14847
• Pubmed ID:
  35434784
• Pubmed Central ID:
  PMC9578149
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  39
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6ee16aa5a58a76746b99197cad6aeaf0ea7be14b435e021e38fa46d15d07d767
• Download URL:
  https://stacks.cdc.gov/view/cdc/121826/cdc_121826_DS1.pdf
• File Type:
  [PDF - 191.36 KB ]