(OR35-01-24) Health and Economic Impact of Produce Prescription for Diabetes Patients in 50 States

Objectives: Although produce prescription programs (Produce RX) have been shown to improve dietary quality and cardiometabolic risk factors, the long-term impact of Produce RX on health and economic burdens at the state level, where Medicaid and commercial plans for coverage of such programs are made, remains unknown.

Methods: We used a validated DOC-M microsimulation model to quantify the long-term effects of implementing Produce RX in cardiovascular disease (CVD) events, quality-adjusted life-years, costs, and cost-effectiveness among low-income individuals with diabetes in 50 U.S. states. The model incorporated state-representative baseline characteristics for low-income individuals with diabetes from BRFSS, estimated intervention effects and intervention costs pooled from 20 Produce RX programs, diet-disease effects from meta-analyses, and healthcare expenditures and utilities derived from national MEPS data.

Results: Between 1,540,260 (California) and 9,468 (Wyoming) adults, or 10.8% (New Mexico) and 3.5% (Utah) of adults would be eligible for Produce RX. Over a lifetime, Produce RX would avert between 45,900 CVD events (95%CI, 26,600-71,500) in California to 328 (154-564) in Wyoming, or between 5.8% (South Dakota) to 4.7% (New York) of all projected events. Accounting for implementation costs, Produce RX would be cost-saving from a healthcare perspective in all states, with the highest net cost savings per patient in Connecticut ($2520), Massachusetts ($2300), and New York ($2149); and lowest, in Idaho ($326), Colorado ($368), and Kentucky ($480). The program was also cost-saving in all states at 10 years of intervention (with net per capita cost savings ranging from $73 to $1246 across states), and in most states (n=47) at 5 years.

Conclusions: Produce RX for low-income patients with diabetes is projected to significantly reduce CVD incidence with net cost savings in all 50 states, and with important variations that help inform state-level decision-makers.

Funding Sources: National Heart, Lung, & Blood Institute (NHLBI), National Institutes of Health (NIH)
American Diabetes Association