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CostEffectiveness of a CommunityBased Diabetes Prevention Program with Participation Incentives for Medicaid Beneficiaries

Objective: To examine the costeffectiveness of a communitybased Diabetes Prevention Program (DPP) for Medicaid beneficiaries from the perspective of the health care sector.

Data Sources/Study Setting: A total of 847 Medicaid enrollees at high risk for type 2 diabetes participating in a communitybased DPP.

Study Design: Pre and post clinical outcome and cost data were used as inputs into a validated diabetes simulation model. The model was used to evaluate qualityadjusted life years (QALYs) and health care costs over a 40year time horizon from the perspective of the health care sector.

Data Collection/Extraction Methods: Clinical outcome and cost data were derived from a study examining the effect of financial incentives on weight loss.

Principal Findings: Study participants lost an average of 4.2 lb (p < .001) and increased highdensity lipoprotein cholesterol by 1.75 mg/dl (p = .002). Intervention costs, which included financial incentives for participation and weight loss, were $915 per participant. The incremental costeffectiveness ratio was estimated to be $14,011 per QALY but was sensitive to the time horizon studied.

Conclusions: Widespread adoption of communitybased DPP has the potential to reduce diabetes and cardiovascularrelated morbidity and mortality for lowincome persons at high risk for diabetes and may be a costeffective investment for Medicaid programs.

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