Western Sydney Diabetes Prevention Strategic Alliance: Economic case for prevention of type 2 diabetes

Abstract

Introduction: In Western Sydney, over 50% of the residents are overweight and at high risk of developing diet-related chronic disease. It is a diabetes ‘hotspot’ with a rate 1.5 times higher than the Sydney average. At a cost of $14.6 billion per annum and at current population growth rates, by 2019, diabetes will be the most costly disease in Australia and a debilitating burden on the health system. Health cannot solve the problem alone. The solution lies in prevention through a multi-sectoral, transformational, long-term prevention strategy with scaled up investment. Policy context/ objective: Western Sydney Local Health District, NSW Health and the NSW Department of Premier and Cabinet have partnered with over 50 organisations including the three levels of government, non-government organisations and the private sector to form the Western Sydney Diabetes Prevention Alliance. The Alliance aims to produce a paradigm shift in the local environment to allow residents to purchase and prepare healthy food, have access to safe areas for physical exercise and reduce dependency on car travel, through local and governmental interventions and improved urban design. Targeted population: The Alliance has consulted with a number of consumers and experts in their field over a 9-month period, and analysed the most effective local and international interventions to produce a prevention strategy. The strategy is supported by 15 individual initiatives. The strategy aims to prevent 10,000 new cases of diabetes by targeting 270,000 people within a population of 870,000. The target populations include 220,000 children, 44,000 people at high risk and 6,000 ‘healthy’ adults. Highlights: An economic case cost-benefit analysis produced by PwC predicts an investment of $124.27m would realise total net benefits of $577.00m to 2030. Ten of the proposed initiatives are included in this model, but the number and content may alter over time. The benefits will be achieved through savings in healthcare costs, government subsidies and lost productivity. The costs and benefits have been modelled on running each initiative over 14 years from 2017 to 2030. The costing model is based on the average annual cost of the treatment of a person with diabetes, includes a decay rate of the efficacy of interventions, as well as the inclusion of the direct costs of setting up and running each program on an annual basis. Costs of the initiatives have been based on data from existing programs and commercial data provided by Alliance members. The establishment of a Prevention Hub has also been included for sustainability. This cost-benefit analysis has been developed to attract financial support from both government and the private sector. Transferability: The objectives are to improve the overall health of western Sydney residents, as well as to become an exemplar that can be adopted by other health districts throughout Australia Conclusion: The benefits of the Alliance lie in the ongoing collaboration of previously disparate organisations to address a major health and societal issue, the shared vision to reach the majority of residents and the goal to halt a relentless progression toward diabetes within the local community.