The National Changing Diabetes((R) )Program (NCDP), a program of Novo Nordisk, commends Representative Donna M. Christensen, M.D. (D-VI) and Michael C. Burgess, M.D. (R-TX) for sponsoring legislation that will lead to a more accurate assessment of the cost and benefits of preventive health, including preventing complications and delaying progression of chronic diseases such as diabetes.
The bipartisan Preventive Health Savings Act of 2009 (HR 3148), introduced Thursday, July 9, 2009, calls on the Congressional Budget Office (CBO) to weigh clinical or observational studies when modeling projected costs and savings related to preventive health, and in certain circumstances, look beyond the traditional 10-year budget window. These concepts, supported by researchers at the University of Chicago in a paper published today in Health Affairs, can inform the health care reform debate that will be taken up by Congress this fall.
Currently, the CBO, which provides Congress with impartial analyses of the costs of federal programs, uses traditional economic and actuarial approaches to assess the financial impact or "scores'' of health programs across a 10-year window of time. But in many cases, for chronic, progressive diseases such as diabetes, the true value of prevention and improved treatment outcomes become apparent only when assessed over a longer time period.
"Health care reform represents a once-in-a-lifetime opportunity for creating a system which values prevention, but this promise will not be fully realized without modernizing the way Congress scores preventive health legislation," Congresswoman Christensen said. "The Preventive Health Savings Act requires CBO to conduct an initial analysis to determine whether the preventive health measure would result in substantial savings outside the scoring window, and if those savings exist, CBO must include an estimate and description of those future-year savings in its budget projections."
"As a doctor, I know an ounce of prevention is worth a pound of cure. Preventive measures can save money in the long-term,'' said Representative Burgess. "Today the federal budget scoring process inadvertently skews Congressional decision-making to the short term. This bill calls on the CBO to adjust their metrics and provide Congress accurate 'scoring' of both the long term costs and benefits of preventive health."
Science has pointed toward promising interventions that improve the lives of people living with diabetes. Large studies have shown that early, intensive treatment to reduce blood glucose levels can delay or prevent debilitating and costly complications of diabetes, such as heart disease, stroke, blindness, kidney failure and amputation.
"It is essential for Congress to realistically consider the financial benefits of prevention. Research has shown that prevention measures ranging from early screening to having the tools to successfully manage diabetes are the cost-effective actions we need to take to stem the tide of the diabetes epidemic," said Janel Wright, Chair of the American Diabetes Association's Advocacy Committee.
"By including epidemiological data - the results of clinical trials and other studies that show the impact of prevention programs and good disease management - and better modeling in making its projections, the CBO can provide more accurate information to Congress," said Bob Doherty, Senior Vice President, Governmental Affairs and Public Policy, American College of Physicians.
Chronic diseases are the leading cause of death and disability in the United States, and treatment of these diseases accounts for 75% of national health care spending. Diabetes alone already affects nearly 24 million Americans and is expected to rise to 50 million by 2025.
"Vision benefits are often seen as non-core health care, but a recent study demonstrated early detection of chronic diseases through eye exams translated into significant cost savings for companies," said Rob Lynch, President and CEO, VSP Vision Care. "Results suggest that large employers such as the U.S. Federal Government, which includes over 8 million employees, dependents and retirees, could save an estimated $423 million annually in potential cost avoidance due to early detection through eye exams."
Diabetes cost the U.S. an estimated $218 billion in 2007, in medical care and lost productivity. A report commissioned by NCDP found the federal government spends nearly $80 billion annually to treat people with diabetes and its complications, while only $4 billion is spent on disease prevention and health promotion activities that could reverse or delay the course of the disease.
"Much of the healthcare debate is going to focus on chronic disease,'' says Michael J. O'Grady, Ph.D., Senior Fellow at the National Opinion Research Center at the University of Chicago, who conducted research for NCDP that was the focus of a briefing on Capitol Hill that was sponsored by Reps. Christensen and Burgess. "The whole point of this effort is to arrive at non-partisan, rigorous, science-based estimates that inform policymakers so they have the most accurate and comprehensive information to make the best decisions.''
"Congress needs solid, scientific information to make the choices needed for Americans in the 21st century," said Dana Haza, senior director of NDCP, a diabetes leadership initiative by Novo Nordisk to drive health systems change at the national and local level. "For the first time, Congress will have a comprehensive estimate of the aggregate costs and savings from preventive health and how CBO arrived at its calculations," said Haza.
"Disease prevention and improved care coordination, along with delivery system reform, are at the heart of controlling the high and rising cost of health care," said Ken Thorpe, Ph.D., executive director, the Partnership to Fight Chronic Disease. "We need to do all we can to provide Congress with a better understanding of how disease prevention can both reduce costs and improve the quality of life for all Americans."
"Diabetes costs the nation $218 billion each year in medical expenses and lost productivity. Yet the evidence shows that with early, aggressive treatment, many of the costly and debilitating complications of diabetes can be delayed - or avoided entirely," said Lana Vukovljak, MA, MS, Chief Executive Officer, American Association of Diabetes Educators (AADE). "But it takes an investment up front, in the early years of the disease, to head off huge expenses years later."