TABLE 2—
Cost-Effectiveness Analysis: United States
| 10-Year |
Life-Course |
|||||
| Baseline | Cash | CSA | Baseline | Cash | CSA | |
| DALYs accumulated, mean (95% CI) per 10 000 population | ||||||
| Atherosclerotic cardiovascular disease events | 2 256 (2 244, 2 273) | 2 138 (2 215, 2 158) | 2 039 (2 027, 2 058) | 6 469 (6 434, 6 511) | 6 122 (6 083, 6 163) | 5 829 (5 788, 5 871) |
| Incident diabetes | 214 (205, 222) | 179 (172, 188) | 153 (145, 161) | 1 344 (1 316, 1 374) | 1 141 (1 115, 1 167) | 972 (947, 992) |
| End-stage renal disease | 512 (503, 522) | 504 (493, 515) | 495 (485, 505) | 2 524 (2 498, 2 548) | 2 431 (2 397, 2 455) | 2 355 (2 322, 2 383) |
| Diabetic neuropathy | 1 253 (1 237, 1 269) | 1 181 (1 170, 1 197) | 1 121 (1 107, 1 134) | 4 428 (4 391, 4 459) | 4 148 (4 112, 4 182) | 3 907 (3 872, 3 937) |
| Diabetic retinopathy | 957 (947, 968) | 895 (883, 908) | 845 (833, 855) | 3 457 (3 420, 3 490) | 3 217 (3 188, 3 345) | 3 010 (2 980, 3 038) |
| All-cause mortality | 3 085 (3 059, 3 112) | 2 955 (2 925, 2 983) | 2 837 (2 808, 2 868) | 6 574 (6 526, 6 620) | 6 404 (6 346, 6 454) | 6 231 (3 872, 3 937) |
| Total | 8 277 (8 195, 8 366) | 7 854 (7 768, 7 950) | 7 490 (7 405, 7 580) | 24 797 (24 584, 25 001) | 23 463 (23 241, 23 666) | 22 304 (22 084, 22 510) |
| Health care costs (economic losses), mean $ (95% CI) in millions per 10 000 population | ||||||
| Intervention costs, including overhead | . . . | 33.08 (33.07, 33.09) | 53.79 (53.77, 53.80) | . . . | 88.94 (88.91, 88.98) | 144.49 (144.38, 144.55) |
| Atherosclerotic cardiovascular disease events | 63.70 (63.29, 64.07) | 59.93 (59.52, 60.30) | 61.67 (61.29, 62.02) | 87.98 (87.54, 88.38) | 82.81 (82.46, 83.17) | 85.20 (84.76, 85.60) |
| Incident diabetes | 8.68 (8.57, 8.79) | 6.87 (6.77, 6.96) | 7.69 (7.61, 7.80) | 15.68 (15.60, 15.78) | 12.61 (12.52, 12.70) | 14.05 (13.97, 14.14) |
| End-stage renal disease | 42.84 (42.16, 43.54) | 42.26 (41.34, 43.04) | 42.64 (41.74, 43.50) | 76.20 (75.32, 77.14) | 73.14 (72.24, 74.05) | 74.44 (73.54, 75.36) |
| Diabetic neuropathy | 37.36 (37.10, 37.66) | 36.10 (35.82, 36.37) | 36.69 (36.35, 36.97) | 55.04 (54.79, 44.32) | 52.63 (52.33, 52.94) | 53.74 (53.45, 54.06) |
| Diabetic retinopathy | 12.05 (11.95, 12.14) | 11.27 (11.16, 11.37) | 11.63 (11.51, 11.73) | 18.45 (18.30, 18.60) | 17.08 (16.97, 17.20) | 17.72 (17.60, 17.83) |
| Total | 164.63 (157.78, 166.21) | 189.51 (187.68, 191.13) | 214.11 (212.27, 215.83) | 253.35 (251.55, 255.22) | 327.23 (235.42, 329.04) | 389.64 (387.76, 391.53) |
| Societal savings (economic gains), mean $ (95% CI) in millions per 10 000 population | ||||||
| Agricultural sector net profit gains | . . . | 40.26 (40.25, 40.28) | 52.56 (52.54, 52.58) | . . . | 108.26 (108.21, 108.30) | 141.20 (141.15, 141.26) |
| Disease-related economic productivity gains | . . . | 50.59 (50.34, 50.86) | 51.68 (51.44, 51.94) | . . . | 220.58 (219.44, 221.59) | 227.44 (226.36, 228.54) |
| Total | . . . | 90.85 (90.58, 91.13) | 104.24 (103.98, 104.52) | . . . | 328.84 (327.65, 329.89) | 368.64 (367.50, 369.80) |
Note. CI = confidence interval; CSA = community-supported agriculture; DALYs = disability-adjusted life years. Discounted DALYs and costs, from a health care and societal perspective, estimated under the baseline (preintervention), cash intervention, and CSA intervention scenarios over 10-y and life-course time horizons. DALYs and costs were discounted at a 3% annual rate. The societal perspective includes cost savings attributable to increased agricultural economic sector profits and workplace productivity attributable to lower disease events.