OBJECTIVE: To describe the costs of the Diabetes Prevention Program (DPP) interventions to prevent or delay type 2 diabetes. RESEARCH DESIGN AND METHODS: We describe the direct medical costs, direct nonmedical costs, and indirect costs of the placebo, metformin, and intensive lifestyle interventions over the 3-year study period of the DPP. Resource use and cost are summarized from the perspective of a large health system and society. Research costs are excluded. RESULTS: The direct medical cost of laboratory tests to identify one subject with impaired glucose tolerance (IGT) was $139. Over 3 years, the direct medical costs of the interventions were $79 per participant in the placebo group, $2,542 in the metformin group, and $2,780 in the lifestyle group. The direct medical costs of care outside the DPP were $272 less per participant in the metformin group and $432 less in the lifestyle group compared with the placebo group. Direct nonmedical costs were $9 less per participant in the metformin group and $1,445 greater in the lifestyle group compared with the placebo group. Indirect costs were $230 greater per participant in the metformin group and $174 less in the lifestyle group compared with the placebo group. From the perspective of a health system, the cost of the metformin intervention relative to the placebo intervention was $2,191 per participant and the cost of the lifestyle intervention was $2,269 per participant over 3 years. From the perspective of society, the cost of the metformin intervention relative to the placebo intervention was $2,412 per participant and the cost of the lifestyle intervention was $3,540 per participant over 3 years. CONCLUSIONS: The metformin and lifestyle interventions are associated with modest incremental costs compared with the placebo intervention. The evaluation of costs relative to health benefits will determine the value of these interventions to health systems and society.
RCT Entities:
OBJECTIVE: To describe the costs of the Diabetes Prevention Program (DPP) interventions to prevent or delay type 2 diabetes. RESEARCH DESIGN AND METHODS: We describe the direct medical costs, direct nonmedical costs, and indirect costs of the placebo, metformin, and intensive lifestyle interventions over the 3-year study period of the DPP. Resource use and cost are summarized from the perspective of a large health system and society. Research costs are excluded. RESULTS: The direct medical cost of laboratory tests to identify one subject with impaired glucose tolerance (IGT) was $139. Over 3 years, the direct medical costs of the interventions were $79 per participant in the placebo group, $2,542 in the metformin group, and $2,780 in the lifestyle group. The direct medical costs of care outside the DPP were $272 less per participant in the metformin group and $432 less in the lifestyle group compared with the placebo group. Direct nonmedical costs were $9 less per participant in the metformin group and $1,445 greater in the lifestyle group compared with the placebo group. Indirect costs were $230 greater per participant in the metformin group and $174 less in the lifestyle group compared with the placebo group. From the perspective of a health system, the cost of the metformin intervention relative to the placebo intervention was $2,191 per participant and the cost of the lifestyle intervention was $2,269 per participant over 3 years. From the perspective of society, the cost of the metformin intervention relative to the placebo intervention was $2,412 per participant and the cost of the lifestyle intervention was $3,540 per participant over 3 years. CONCLUSIONS: The metformin and lifestyle interventions are associated with modest incremental costs compared with the placebo intervention. The evaluation of costs relative to health benefits will determine the value of these interventions to health systems and society.
Authors: E P Steinberg; B Gutierrez; A Momani; J A Boscarino; P Neuman; P Deverka Journal: Health Aff (Millwood) Date: 2000 Mar-Apr Impact factor: 6.301
Authors: Richard R Rubin; Wilfred Y Fujimoto; David G Marrero; Tina Brenneman; Jeanne B Charleston; Sharon L Edelstein; Edwin B Fisher; Ruth Jordan; William C Knowler; Lynne C Lichterman; Melvin Prince; Patricia M Rowe Journal: Control Clin Trials Date: 2002-04
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Rachel Ballard-Barbash; Sally Hunsberger; Marianne H Alciati; Steven N Blair; Pamela J Goodwin; Anne McTiernan; Rena Wing; Arthur Schatzkin Journal: J Natl Cancer Inst Date: 2009-04-28 Impact factor: 13.506
Authors: Ronald T Ackermann; Emily A Finch; Karen K Schmidt; Helena M Hoen; Laura M Hays; David G Marrero; Chandan Saha Journal: Contemp Clin Trials Date: 2013-10-29 Impact factor: 2.226
Authors: Michael S Lawlor; Caroline S Blackwell; Scott P Isom; Jeffrey A Katula; Mara Z Vitolins; Timothy M Morgan; David C Goff Journal: Am J Prev Med Date: 2013-04 Impact factor: 5.043
Authors: Evan M Forman; Stephanie G Kerrigan; Meghan L Butryn; Adrienne S Juarascio; Stephanie M Manasse; Santiago Ontañón; Diane H Dallal; Rebecca J Crochiere; Danielle Moskow Journal: J Behav Med Date: 2018-08-25