2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

330126
Impact on Medical Care Expenditures of Individuals Progressing from Prediabetes to Diabetes


Monday, November 2, 2015 : 12:45 p.m. - 1:00 p.m.

Tamkeen Khan, PhD, Improving Health Outcomes- Outcomes Analytics, American Medical Association, Chicago, IL
Stavros Tsipas, MA, Improving Health Outcomes- Outcomes Analytics, American Medical Association, Chicago, IL
Gregory Wozniak, PhD, Improving Health Outcomes- Outcomes Analytics, American Medical Association, Chicago, IL
Audio (mp3) recording Recorded Presentation (mp4)
The United States has 86 million adults with prediabetes (pre-DM). Individuals with pre-DM can prevent or delay the onset of diabetes (DM) through lifestyle modifications, mitigating the medical and economic burdens associated with the disease. The American Medical Association and Centers for Disease Control and Prevention are focusing efforts towards encouraging physicians to screen for pre-DM and refer eligible individuals to evidence-based diabetes prevention programs (DPP).  This study uses the Truven MarketScan® Laboratory commercial database to identify individuals with pre-DM, describe a three year progression of medical care expenditures among these individuals who are later diagnosed with DM relative to those who are not, and estimates the potential savings and return on investments (ROI) associated with DPP participation.

The results find individuals with pre-DM later diagnosed with DM have medical care expenditures nearly one-third greater compared to their counterparts (p<0.05).  Individuals diagnosed with DM had on average $2,800 more in medical care expenditures. 

For employers with 1,000 employees with similar risk factors to those examined, implementation of a DPP would cost roughly $450 per employee and save 28 individuals from becoming diabetic.  Net savings over three years for this population would be approximately $150,000 in direct medical spending, translating to roughly $225 monthly per member.  Based on this, ROI over three years in a DPP for these employers would be 182%.  Overall net savings and ROI would be higher when including longer term trends and savings from lost productivity, suggesting that investments in DPP are worthwhile in the long run.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related public policy

Learning Objectives:
Describe the progression of medical care expenditures among individuals with prediabetes (pre-DM). Compare expenditures between individuals who are later diagnosed with diabetes relative to those who do not progress to diabetes. Assess the potential savings and return on investments associated with participation in evidence based Diabetes Prevention Programs.

Keyword(s): Diabetes, Economic Analysis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Senior Economist for the American Medical Association's 'Improving Health Outcomes' team. My research focuses on economic studies of costs associated with diseases impacting a large percentage of the US population, physician and patient behaviors impact on outcomes and cost of care, and development of evaluation protocols to asses the impact of the team's initiatives.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3281.0: Economic Impact and Return on Investment in Public Health