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Selecting a target population for type 2 diabetes lifestyle prevention programs: A cost-effectiveness perspective
Joohyun Park1, Ping Zhang1, Hui Shao2
1Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Summary
Lifestyle change programs for type 2 diabetes prevention are most cost-effective for high-risk individuals. The in-person group format is optimal for many, while the individual format suits the highest risk groups.
Area of Science:
- Public Health
- Health Economics
- Preventive Medicine
Background:
- Lifestyle change programs (LCPs) are crucial for preventing type 2 diabetes (T2D).
- The cost-effectiveness (CE) of LCPs varies significantly based on participant T2D risk.
- Understanding optimal program delivery formats is essential for maximizing public health impact.
Purpose of the Study:
- To determine the T2D risk thresholds for cost-effective LCP delivery across different formats.
- To compare the CE of individual (in-person, digital) and group (in-person) LCP formats.
- To guide decision-making in targeting populations for T2D prevention interventions.
Main Methods:
- Utilized the CDC-RTI T2D CE Simulation model for analysis.
- Simulated nationally representative populations based on NHANES data (2011-2016).
- Calculated incremental cost-effectiveness ratios (ICERs) per quality-adjusted life year (QALY) gained over 25 years from a healthcare system perspective.
Main Results:
- An annual T2D incidence of ≥5% was required for in-person individual programs to be cost-effective ($50,000/QALY).
- Digital individual programs required ≥4% incidence, and in-person group programs required ≥3% incidence.
- In-person group programs dominated digital individual programs for risks ≥4%; individual programs were superior only for risks ≥8%.
Conclusions:
- Targeting LCPs based on individual T2D risk significantly impacts cost-effectiveness.
- In-person group programs offer broad cost-effectiveness for T2D prevention.
- Specific risk stratification is key for optimizing resource allocation in T2D prevention.
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