Published in Population Health Management, the study demonstrates how preventing the onset of type 2 diabetes can reduce annual health care costs by thousands of dollars per patient and generate large positive returns on investment (ROI) for health systems, insurers and employers.
Researchers in the study used individual-level claims data from more than 8,000 commercially insured adults to estimate medical expenditures among individuals with prediabetes. Data on expenditures were combined with findings from previous studies to estimate net savings and ROI if they were to participate in a Centers for Disease Control and Prevention (CDC)-recognized diabetes prevention program (DPP).
Based on an analysis of the data, researchers found that:
• Patients who develop diabetes are very costly. Expenditures during the one-to-three-year period following HbA1c screening are one-third higher for those who develop diabetes. That amounts to an annual average of $2,671 per patient.
• Preventing diabetes is more than a vital public health solution—it’s an effective financial strategy. Because the annual cost differential for patients who develop diabetes is significant, “The three-year ROI for a National DPP is estimated to be as high as 42 percent,” wrote the study’s authors, Tamkeen Khan, Ph.D., Stavros Tsipas and Gregory Wozniak, Ph.D., all of the American Medical Association (AMA).
• Diabetes prevention programs are still one of the best solutions for improving health outcomes and reducing burdensome medical expenditures. In fact, patient participation in a CDC-recognized DPP in a community-based or primary care setting costs between $400 and $500 per person—far less than the average annual medical care expenditure savings. Not to mention previous research confirms that the impact of these programs extends beyond dollar signs: People who complete DPPs are one-third less likely to develop type 2 diabetes after 10 years.
Using results from this analysis and findings in previous studies, the study authors estimated just 14 percent of patients who complete a DPP will be diagnosed with diabetes within three years, compared with 29 percent of those who do not participate.
DPPs in California: The California Medical Association's plan to prevent diabetes
These recent findings underscore precisely why AMA and the California Medical Association (CMA) have partnered to advance patient participation in DPPs throughout our state and galvanize support for community-based interventions.
More than 86 million Americans are living with prediabetes, but most of them are unaware. In California alone, an estimated 13 million adults have the condition, putting them at high risk of developing type 2 diabetes without intervention.
"The diabetes epidemic is out of control and getting worse. In California, diabetes rates have increased by 35 percent since 2001," says CMA President Ruth Haskins, M.D. "In partnership with AMA we are working hands-on with California's physicians to implement meaningful diabetes prevention efforts to improve the health of Californian's and ultimately improve the health of people across the country.”
The partnership is part of Prevent Diabetes STAT, a strategic effort launched by AMA in collaboration with the CDC in 2015 to engage more Americans with prediabetes and slow the progression of type 2 diabetes.
"The goal of this partnership is to get patients with prediabetes into proven lifestyle change programs that have been shown to cut the risk in half of progressing to type 2 diabetes," said AMA President Andrew W. Gurman, M.D. "By working with a variety of practices and health systems within California, we are learning the best ways to implement processes for screening, testing and referring across different clinical settings. We will use these models in the future to support other states as they adopt a similar process—helping even more Americans stave off or delay type 2 diabetes to improve health outcomes."
Calculate DPP savings for your patient population
An online tool from AMA helps employers, insurers, health systems and others to calculate net savings and ROI for their sample populations. Play with this calculator to see how upping the share of your patients who enroll in a DPP can have a sizeable effect on the number who develop diabetes and how much money can be saved through prevention.
To find a CDC-recognized program near you or online, visit https://nccd.cdc.gov/DDT_DPRP/Programs.aspx.
For more diabetes prevention resources from AMA and CMA, visit http://www.cmanet.org/issues-and-advocacy/cmas-top-issues/public-health/diabetes-prevention/