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Does diabetes prevention pay for itself? Evaluation of the M.O.B.I.L.I.S. program for obese persons

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Abstract

In response to the growing burden of obesity, public primary prevention programs against obesity have been widely recommended. Several studies have estimated the cost-effectiveness of diabetes-prevention trials for different countries. Nevertheless, it is still controversial if prevention conducted in more real-world settings and among people with increased risk but not yet exhibiting increased glucose tolerance can be a cost-saving strategy to cope with the obesity epidemic. We examine this question in a simulation model based on the results of the M.O.B.I.L.I.S program, a German lifestyle intervention to reduce obesity, which is directed on the high-risk group of people who are already obese. The contribution of this paper is the use of 4-year follow-up data on the intervention group and a comparison with a control group formed by SOEP respondents as inputs in a Markov model of the long-term cost savings through this intervention due to the prevention of type 2 diabetes. We show that from the point of view of a health insurer, these programs can pay for themselves.

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Notes

  1. We account for the actual length of the follow-up (between 3 and 6 years) and afterwards linearly adjust the annual transition probabilities to the average follow-up period of 4 years in both groups.

  2. Since after the end of the program members of the intervention group on average gain weight faster than members of the control group due to the rebound effect, this assumption also prevents the implausible outcome that after a number of years the former are on average heavier than the latter.

  3. Including macrovascular disease, nephropathy, neuropathy, and retinopathy.

  4. As Table 4 contains cost savings, these differences of 227 and 269 € appear as negative numbers.

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Acknowledgments

This research was funded by the German Ministry of Education and Research (BMBF) under the grant no. 0315671 and by BARMER GEK. The authors are grateful to M.O.B.I.L.I.S. e.V. for collecting and providing the data. Valuable comments by Rolf Holle, Normann Lorenz, and Jürgen Maurer as well as participants of the iHEA World Congress 2013 in Sydney, the Augsburg Workshop on the Economics of Health Behaviors and Prevention 2013 and of the Annual Meeting of the German Health Economics Association (DGGÖ) 2014 in Munich and two anonymous referees are gratefully acknowledged.

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  1. Department of Economics, University of Konstanz, Fach 135, 78457, Constance, Germany

    Jan Häußler & Friedrich Breyer

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  1. Jan Häußler
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Correspondence to Jan Häußler.

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Häußler, J., Breyer, F. Does diabetes prevention pay for itself? Evaluation of the M.O.B.I.L.I.S. program for obese persons. Eur J Health Econ 17, 379–389 (2016). https://doi.org/10.1007/s10198-015-0682-0

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