title: Return on Investment for Digital Behavioral Counseling in Patients With Prediabetes and Cardiovascular Disease.
abstract: BACKGROUND
  We calculated the health and economic impacts of participation in a digital behavioral counseling service that is designed to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with prediabetes and cardiovascular disease risk factors (Prevent, Omada Health, San Francisco, California). This program enhances the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. Participants completed a 16-week core program followed by an ongoing maintenance program.
  
  
  METHODS
  Analysis was conducted for 2 populations meeting criteria for lifestyle intervention: 1) prediabetes (n = 1,663), and 2) high cardiovascular disease risk (n = 2,152). The Markov-based model simulated clinical and economic outcomes related to obesity and diabetes annually over 10 years for the 2 defined populations. Comparisons were made between participants and propensity-matched controls from the community.
  
  
  RESULTS
  The return-on-investment break-even point was 3 years in both populations. Simulated return on investment for the population with prediabetes was $9 and $1,565 at years 3 and 5, respectively. Simulated return on investment for the population with cardiovascular disease risk was $96 and $1,512 at years 3 and 5, respectively. Results suggest that program participation reduces diabetes incidence by 30% to 33% and stroke by 11% to 16% over 5 years.
  
  
  CONCLUSIONS
  Digital Behavioral Counseling provides significant health benefits to patients with prediabetes and cardiovascular disease and a positive return on investment.
authors.affiliation: IHS Life Sciences, 1150 Connecticut Ave NW, Suite 401, Washington, DC 20036. Email: wayne.su@ihs.com.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Su
authors.affiliation: IHS Life Sciences, Washington, DC.
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.affiliation: IHS Life Sciences, Washington, DC.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Dall
authors.affiliation: IHS Life Sciences, Washington, DC.
authors.forename: William
authors.initials: W
authors.lastname: Iacobucci
authors.affiliation: University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Leigh
authors.initials: L
authors.lastname: Perreault
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011236:Prediabetic State / Q000517:prevention & control*; D015431:Weight Loss
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