Screening Shows Cost-Savings in Dysglycemia and Diabetes

JUNE 28, 2010
Screening patients for dysglycemia and diabetes has been shown to be cost-saving when compared with not screening, according to a poster presented at the American Diabetes Association’s 70th Scientific Sessions today in Orlando.
The study, which was led by author Ranee Chatterjee, MD, MPH, from the Johns Hopkins University, examined the effects of screening on the overall costs of diabetes from both a health system and societal perspective. A population of 1,573 volunteers was screened for both prediabetes and diabetes by random plasma and capillary glucose tests which were then repeated an hour after the administration of a 50g oral glucose challenge. On their second visit, A1C and standard 2-hour 75g OGTT were tested. The costs considered in the study were calculated over a 3-year period.
The results were based on screening everyone versus not screening at all and then both health system and societal costs were calculated. The societal costs include the health-system costs, as well as the patient’s time to undergo the test, true positive costs (the direct non-medical costs and indirect costs related to treatment), and false negative costs (indirect costs due to lost productivity from diabetes).
The results showed that when using the GCTpl to test for dysglycemia, the health-system costs were $216,007 and the societal costs were $325,735; for no testing at all, the health-system costs were $242,737 and societal costs of $316,786. In testing for diabetes using the GCTpl test, the health-system costs were $66,878 with a societal cost of $109,946; for not testing, health-system costs were $95,710 and societal costs were $146, 426. These results led the authors to deduce that screening and treatment would be a cost-saving tool for both diabetes and dysglycemia in terms of health-system costs and for diabetes from a societal perspective.
The cost savings in this study were more pronounced when high-risk peoples were considered; the costs of not screening increased in groups who had a higher risk or diabetes or prediabetes. On average, the cost-savings for screening people with a BMI of 25-35 would be 7.3% and for those with a BMI over 35 would be 21.5%. For people aged 40-55 years the cost-savings would register at 8.1% while for those older than 55 the savings would be 17.1%.
But, the authors emphasize that screening for those patients who have a BMI less than 25 or are younger than 40 would result in net cost increases for most screening tests. But if low-risk people were removed from the cohort, the savings would have registered as much higher; the GCTpl test showed the greatest amount of cost savings in high-risk groups.
Since the GCTpl test is generally the least expensive screening tool, the authors concluded, “the GCTpl test should be considered for routine use as an opportunistic screen for diabetes and dysglycemia.”  

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