Diabetes Drug Metformin Delays Disease, Lowers Health Costs - Study

By: Jennifer Corbett Dooren
Source from: http://online.wsj.com/article/BT-CO-20110628-712090.html

WASHINGTON (Dow Jones)--Treating people at risk of developing diabetes with a common diabetes drug metformin lowered the risk of developing the disease, along with slightly cutting health-care costs, according to an analysis of a landmark diabetes prevention program.

The cost analysis of the National Institutes of Health funded program showed that an intensive lifestyle intervention was more effective at cutting the risk of developing diabetes compared to metformin, but at a cost of about $1,500 over 10 years. The analysis was presented Tuesday at the American Diabetes Association's annual meeting.

Doctors said the lifestyle intervention cost is similar to treatment with cholesterol-lowering medications that aim to prevent heart attacks and strokes, and far cheaper than things like kidney dialysis needed by many patients with advanced stages of diabetes.

The diabetes prevention program was a 10-year study that compared the diabetes drug metformin and a lifestyle intervention that was aimed at helping people lose at least 7% of their body weight through diet, exercise and behavioral counseling, compared to people in a placebo group.

Patients in the study were overweight and had elevated blood sugar levels, which put them at high risk of developing type 2 diabetes, the most common form of the disease. About 26 million Americans have diabetes.

One of the diabetes prevention program's researchers, William Herman, a professor of medicine at the University of Michigan, explained that a criticism of the initial study was that the lifestyle intervention likely wouldn't replicated on a broader scale because it would be too expensive. So Herman looked the cost of medical care in and outside of the study including the cost of metformin and the lifestyle intervention.

The lifestyle intervention started with a 16-lesson curriculum covering diet, exercise and behavior modification that was taught by case managers on a one-on-one basis, followed by monthly individual sessions and group sessions with case managers.

During the first three years of the study the lifestyle intervention cut the risk of developing diabetes by 58% while metformin cut it by 31%, compared to patients where nothing was done. The study was then extended for another seven years with a less intensive lifestyle intervention and metformin.

Over the entire 10 years of the study, those in the lifestyle intervention group had a 31% reduced risk of developing diabetes while those on metformin had a 19% reduced risk compared to patients in the placebo group.

Metformin is an inexpensive generic drug and is usually the first drug given to newly diagnosed type 2 diabetes patients. Herman's analysis showed that giving metformin to patients at high risk of developing the disease reduced overall healthcare costs by about $30 over 10 years.

Herman said it is likely that a lifestyle intervention similar to the one used in the diabetes prevention study conducted on a group basis instead of individually would save the healthcare system money.

Indeed, researchers at Indiana University developed such a program. It is currently being rolled out at YMCAs nationwide with funding from UnitedHealth Group (UNH).