Cost-Effectiveness of Exercise and Diet for Diabetes Prevention

I promised that I would report on the cost-effectiveness studies in the systematic review of exercise and diet therapy for the prevention of diabetes discussed in a previous post.[1]

Most studies end three years after the start of the intervention, while the most substantial potential benefits accrue later. Some studies did not model these longer-term benefits, but most extrapolated over ten years or more. Most used previously published model structures such as the Archimedes model. Incremental Cost-Effectiveness Ratios (ICERs) were calculated in 22 studies, all but two of which showed that the intervention (whether group- or individual-based) was cost-effective at a $50,000 Willingness-to-Pay (WTP) threshold. Two studies (both concerning a group intervention) actually suggested the intervention was cost releasing. Averaged across all studies the ICER was about $13,000 per QALY (quality-adjusted life year). CLAHRC WM is collaborating with CLAHRC East Midlands on a study to prevent later onset diabetes in women who have had gestational diabetes. These models will be useful for the calculation of the incremental cost-utility of our intervention.

— Richard Lilford, CLAHRC WM Director


  1. Li R, Qu S, Zhang P, et al. Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventative Services Task Force. Ann Intern Med. 2015; 163(6):452-60.

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