Working with pharma giant Eli Lilly and Company, chronic disease management company Livongo has completed a retrospective analysis of more than 10,000 paitents, which suggests that Livongo's diabetes program can prevent $88 worth of medical spending per person per month.
Citing an average cost to employers of $68 per person per month, including about $30 worth of diabetes management products, this could indicate an ROI of between $20 and $50 per member per month. The study was published in the Journal of Medical Economics.
“As new mobile technologies become available to help people better manage their chronic conditions, there needs to be reliable data on the association between the use of these technologies and medical spending. Our goal with this study was to evaluate the impact of these technologies,” Christopher Whaley, an assistant adjunct professor of health policy and management at the University of California, Berkeley, and lead author of the study, said in a statement.
After one year, members of Livongo's diabetes program saw a 21.9% decrease in medical spending based on claims data, a savings of $88 per member per month. This included a 10.7% reduction in diabetes-based spending and a 24.6% reduction in spending on office visits. Interestingly, the program was not correlated with any reduction in emergency room or inpatient visits. Additionally, members who were enrolled for a longer time tended to see a larger effect.
The study also looked at program usage and blood glucose levels. The most common usage patterns were clustered on the ends of the spectrum, with 28 percent checking blood glucose 24 days or more each month and 20 percent checking fewer than three days per month, with the other 52 percent spread more or less evenly across the middle of that range.
Unsurprisingly, the study showed that those with well-controlled blood glucose levels had significantly lower medical spending than those with high blood glucose rates.
HOW IT WAS DONE
Three employers participated in the study and offered employees with diabetes membership in the Livongo program, which includes a blood glucometer, free test strips and a software application that offers coaching and tracking. Those who chose to enroll in Livongo and used their testing meter at least once (n = 2,261) were compared to employees of the same firms, with the same benefits, who chose not to enroll (n = 8,741).
Researchers compared the two groups' medical claims data using a multivariable difference-in-difference (DiD) regression model and controlling for other confounding factors. They also looked at blood glucose data for the participant group only, since that data was collected via the Livongo program itself.
Participants were self-selecting and, interestingly, researchers found that the group who chose to participate tended to have higher medical costs to begin with. This, researchers note, is a drawback of the nonrandomized study design, since those who chose to participate in the program might be more motivated in general to manage their health.
WHAT'S THE HISTORY
One of a number of digital chronic condition management companies, Livongo has been in the spotlight lately after the Wall Street Journal reported in March that the company is gearing up for an IPO, potentially the first such IPO in the space in years. At his new paid research site Exits and Outcomes, MobiHealthNews founder Brian Dolan has a deep dive on what the company's S-1 might look like.
Livongo has a few other published studies under its belt, but this is the first to focus on financial rather than clinical outcomes. The involvement of Eli Lilly is also notable in its own right, as it is another example of big pharma taking a serious interest in digital health.
"Digital solutions and on-demand information help empower people with chronic conditions like diabetes to better manage their health," Eric Edgell, senior director of health outcomes at Lilly Diabetes, said in a statement. "That’s why Lilly is focused on research and collaborations with companies such as Livongo to help the people who use our medicines improve their health and lower costs."
ON THE RECORD
“At Livongo, we have the rigor and infrastructure to produce academic studies to determine the overall effectiveness of our clinically-based programs,” Livongo President Dr. Jennifer Schneider, who co-authored the study, said in a statement. “In this study, we determined that utilization of the Livongo for Diabetes program leads to measurable medical cost reductions. This is another great affirmation of the work we are doing to transform the healthcare experience for people living with chronic conditions.”