Cost-Effectiveness Analysis of an Intensive Lifestyle Intervention Versus Usual Care for Latino Youth With Prediabetes

Objective: Lifestyle intervention is a cost-effective approach for preventing type 2 diabetes among adults with prediabetes. The purpose of this study was to examine the cost and incremental cost-effectiveness ratio (ICER) of an intensive lifestyle intervention compared with usual care among youth with prediabetes. Methods: Latino youth ages 12–16 years with obesity and prediabetes were randomised to a 6-month lifestyle intervention (INT, N = 79) or usual care (UC, N = 38). Between-group difference in change in 2-h post-challenge glucose was non-significant at 6 months (7.2 mg/dL; 95% CI, −5.3, 19.7) and 12 months (0.3 mg/dL; 95% CI, −14.1, 14.5). Cost and ICERs were calculated from health care, family and total societal (health care plus family) perspectives in 2019 US Dollars. The study was conducted from May 2016 to March 2020. Results: The estimated societal cost per participant was $1935.21 (95% CI, $1583.12, $2315.05) for the INT and $234.20 ($190.71, $278.61) for the UC during the first 6 months. During the entire 12 months of the trial, the societal cost per participant increased to $468.40 ($379.19, $568.37) for the UC, but there were no additional costs for the INT. The ICER for 2-h glucose for the INT compared with the UC was $222.78 and $4816.57 per mg/dL at 6 and 12 months. Conclusions: Among Latino youth with prediabetes, an intensive lifestyle intervention resulted in a nonsignificant reduction in 2-h glucose at a higher cost compared with usual care.