10 Jul Supply and Demand for Diabetes Prevention Programs
MedicalResearch.com Interview with:
Dr. Alva
Maria L. Alva, DPhil
Economist
RTI International – Research Triangle Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have strong evidence from trials of structured lifestyle intervention programs (e.g. the Diabetes Prevention Program (DPP)) showing that half of new diabetes cases could be avoided if persons with prediabetes changed their lifestyle habits to lose a modest amount of body weight. Moreover, the DPP has been successfully translated into cost-effective community-based prevention interventions, but nationally, these evidence-based interventions (EBIs) are not being used sufficiently. To scale up the implementation of diabetes prevention EBIs, we need to address the challenges of getting organizations to adopt EBIs, and community members to enroll.
Because cost is a primary barrier we wanted to understand what was the perceived value and demand for diabetes prevention programs in NC. And in particular, the role that community health workers and technology could play in program delivery, from the perspectives of both potential recipients (adults at high risk or diagnosed with prediabetes) and decision-makers in healthcare/public health delivery.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: We looked at the willingness to pay for diabetes prevention programs under three scenarios and found that North Carolinians were willing to pay $39 a month if the program was led by a registered professional, such as a nurse, doctor, dietician or pharmacist, $31 if led by a community health worker, and $19 if administered online. However, the cost of providing these programs in North Carolina and across all three scenarios is higher than people’s willingness to pay. The average minimum price per person per month for a local health department or community health center to offer the programs was $79 if led by a registered professional, $49 if led by a community health worker, and $57 if administered online.
The study matches supply and demand estimates to determine the degree of cost sharing between recipients and providers and the extent of likely market coverage of alternate approaches to scaling up and sustaining diabetes prevention programs.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We should consider different approaches to scaling up and sustaining Diabetes Prevention Programs. Given the gap in program cost and willingness to pay by participants, it’s clear that expanding these programs will require new sources of funding too.
The ideal subsidy for these programs should be set at the breakeven point where savings from the program, such as a reduction in health care use, offset program costs. This will help ensure that people get the help they need to prevent or delay type 2 diabetes and that program is financially stable.
It will be important in future research to consider elasticities of demand and supply (how responsive demand and supply are to a change) when evaluating options and the cost sharing transfer that occur as a result of preferences.
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Citation:
Alva ML, Samuel-Hodge CD, Porterfield D, Thomas T, Leeman J. A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina. Prev Chronic Dis 2017;14:160604. DOI: http://dx.doi.org/10.5888/pcd14.160604.
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Last Updated on July 10, 2017 by Marie Benz MD FAAD