Costs Associated With the Primary Prevention of Type 2 Diabetes Mellitus in the Diabetes Prevention Program
- The Diabetes Prevention Program Research Group*
- From the Diabetes Prevention Program Coordinating Center, Biostatistics Center, George Washington University, Rockville, Maryland
Abstract
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.
- AWP, average wholesale price
- CMS, Center for Medicare and Medicaid Services
- DPP, Diabetes Prevention Program
- IGT, impaired glucose tolerance
- LCM, lifestyle case manager
- MCM, medication case manager
- OGTT, oral glucose tolerance tests
Footnotes
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Address correspondence and reprint requests to Diabetes Prevention Program Coordinating Center, Biostatistics Center, George Washington University, 6110 Executive Blvd., Suite 750, Rockville, MD 20852. E-mail: dppmail{at}biostat.bsc.gwu.edu.
Received for publication 21 March 2002 and accepted in revised form 19 August 2002.
- *
↵* The members of the Diabetes Prevention Program Group are listed in reference 1. The members of this writing group are William H. Herman MD, MPH; Michael Brandle MD; Ping Zhang PHD; David F. Williamson PHD, MS; Margaret J. Matulik RN, BSN; Robert E. Ratner MD; John M. Lachin SCD; Michael M. Engelgau MD, MS
↵A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
↵See accompanying editorial on p. 240.
- DIABETES CARE
