OBJECTIVES:: Type 2 diabetes mellitus (T2DM) is a major public health concern affecting millions of Americans and costing billions to the health system. The digital Diabetes Prevention Program (dDPP) is a promising intervention for preventing T2DM among prediabetics based on the highly effective Diabetes Prevention Program. This study will assess the cost-effectiveness of a dDPP in preventing T2DM among prediabetic patients in the United States

METHODS: A Markov cohort model was constructed to assess the cost-effectiveness of dDPP compared to a small group education (SGE) intervention. Transition probabilities from the first year of the model where are derived from two clinical trials. Transition probabilities for longer-term effects from years two through ten using data derived from meta-analyses on lifestyle and DPP interventions. Partial completion of interventions was incorporated to provide a robust prediction of a real-world deployment. Cost and health utilities were derived from published literature. Parameter uncertainties were tested with sensitivity analyses. Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER) from a health system perspective over a 10-year time horizon.

RESULTS: The dDPP dominated the SGE at the $50,000, $100,000, and $150,000 willingness-to-pay thresholds per QALY (WTP). The base case analysis at the $100,000 WTP revealed a dominated ICER, with the SGE costing $1438 more and accruing an average of –0.04 QALYs. Probabilistic sensitivity analysis showed that the dDPP was preferred in 64% of simulations across the three WTP thresholds.

CONCLUSIONS: The findings comparing dDPP to an SGE suggest that a dDPP can be a cost-effective intervention for patients with a high risk of developing type 2 diabetes.