Health and Economic Impact and Cost-Effectiveness of Produce Prescriptions for Diabetes in 50 U.S. States: A Microsimulation Study

Top Things to Know

PRx programs offering free or subsidized fruits and vegetables to patients with diabetes and food insecurity are not only clinically effective but also economically advantageous, reinforcing the value of integrating food into chronic disease management.

By improving dietary intake and lowering BMI and HbA1c, PRx programs can significantly reduce CVD events, demonstrating that food-based therapies can serve as preventive medicine for high-risk populations.

The strongest cost savings were seen in Medicare populations, yet PRx expansion is currently more common in Medicaid and commercial plans. Aligning policy to include PRx in Medicare could enhance equity and maximize health system returns.

Summary of Conclusion/Findings

This microsimulation study evaluated the health and economic impact of implementing produce prescription (PRx) programs for adults aged 40–79 with both diabetes and food insecurity across all 50 U.S. states. Using pooled data from 20 PRx programs, the model projected that PRx could prevent thousands of cardiovascular disease (CVD) events and gain up to 10,000 quality-adjusted life years (QALYs) per state over 10 years. PRx was found to be cost-saving in 43 states and highly cost-effective in nearly all, especially for Medicare populations. States with higher food insecurity and diabetes prevalence (primarily in the South) stood to benefit most. Nationally, PRx programs could yield $2.7 billion in health care savings and $4.2 billion in societal savings over a decade. The study concludes that PRx is a scalable, impactful FIM strategy that can improve health outcomes and reduce costs across diverse payer systems and geographies.