Faculty Profile
William H. Herman, MD, MPH
- Professor, Epidemiology
- Stefan S. Fajans/GlaxoSmithKline Professor of Diabetes
- Professor, Internal Medicine
- Associate Medical Director, Blue Care Network
William H. Herman, MD, MPH previously served as Chief of the Epidemiology and Statistics
Branch in CDC’s Division of Diabetes Translation. He is an internationally recognized
clinician and researcher in diabetes. His clinical interests focus on the prevention
of diabetes and the management of diabetes, its complications, and comorbidities.
His research focuses on the broad areas of epidemiology, clinical trials, health services
research, clinical economics, and health policy. Professor Herman has served as a
principal investigator for the NIH-funded Diabetes Control and Complications Trial
(DCCT), Diabetes Prevention Program (DPP), and Glycemia Reduction Approaches for Diabetes:
A Comparative Effectiveness Study (GRADE). In 2006, he received the American Diabetes
Association’s Kelly West Award for outstanding achievement in epidemiology. He chairs
the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data
and Information Set (HEDIS) Workgroup on Diabetes Quality Measures and has chaired
the American Diabetes Association Professional Practice Committee. From 2018 to 2021,
he chaired the National Clinical Care Commission which, in 2022, made 39 recommendations
to the Congress to leverage federal policies and programs to more effectively prevent
and treat diabetes in the United States.
- MD, Boston University School of Medicine, 1979
- MPH, Epidemiology, University of Michigan School of Public Health, 1993
- BS, Chemistry, Yale University, 1975
Research Interests:
Diabetes, diabetes complications, diabetes epidemiology, health services research, and health economics
Research Projects:
Population health impact of a self-insured employer's policy change to cover weight reduction and diabetes prevention interventions for employees, dependents, and retirees with prediabetes. - In September 2015, the University of Michigan changed its healthcare benefits to cover interventions for weight reduction and diabetes prevention at no out-of-pocket cost. We evaluated the impact of this large-scale policy change on population health by first comparing the yield of three strategies used to identify nondiabetic employees, dependents, and retirees with prediabetes. We also evaluated the incremental benefits of engaging primary care physicians in case finding and referral. Second, we described intervention uptake and reach and assessed individual preferences for in-person and internet-based lifestyle interventions and for metformin therapy. We explained intervention participation based on the Health Belief Model, and further described and compared the uptake, adherence, retention, and change in outcomes (weight, BMI, HbA1c, and quality-of-life) associated with each intervention. Currently, we are modeling the effectiveness, costs, and cost-utility of the interventions relative to no intervention over one and two years. The results of the evaluation will have major implications for benefit design, health policy, and population health.
Real-world effectiveness of structured lifestyle interventions in preventing type 2 diabetes. - In this multicenter project, we are further assessing individual and system-level barriers to and facilitators of participation in the National Diabetes Prevention Program (DPP)/Medicare DPP and evaluating the long-term (5-year) effectiveness and cost-effectiveness of the DPP as implemented in real-world settings. By assessing individual and system level barriers to and facilitators of participation in the DPP, and by evaluating the long-term effectiveness and cost-effectiveness of the DPP as implemented in real-world settings, this study will provide information critical to improving the uptake and impact of the DPP on diabetes in the United States.
The Glycemia Reduction Approaches for Diabetes: A Comparative Effectiveness Study (GRADE) Economic Analysis. - GRADE assessed the comparative effectiveness, safety, and tolerability of four antidiabetic medications with different glucose lowering mechanisms when used in conjunction with metformin to determine which strategy best improves glycemic control over time. We served as a clinical site to recruit, enroll, and retain ~150 patients. We are currently leading the GRADE economic analysis. It assumes that the four treatments differ in their efficacy, cost, and quality-of-life impact. The primary analysis is being performed using an intention-to-treat approach. Participants’ data are being analyzed according to their randomized treatment group whether or not they adhere to their assigned treatment. A sensitivity analysis will be conducted using a “per-protocol” approach. In the per-protocol analysis, outcomes will be assessed by treatment group only for participants who adhered to their randomized treatment and/or responded to their treatment at predefined time points following randomization.
Economic analysis of automated insulin delivery (AID) systems. - Good glycemic control is critical to reduce the incidence of the long-term complications of diabetes. Over the past three decades, evidence has shown that intensive insulin therapy using multiple daily injections (MDI) of insulin and continuous subcutaneous insulin infusion using insulin pumps reduce HbA1c levels and are associated with improved long-term health outcomes for people with type 1 diabetes (T1D). However, the benefits of glycemic control using intensive insulin therapy must be balanced against the risk of hypoglycemia. Recent technological advances have led to the development of sensor-driven devices that use continuous glucose monitoring (CGM) data to adjust insulin infusion automatically. Such automated insulin delivery (AID) systems which are called artificial pancreas (AP) or closed-loop control (CLC) systems combines an insulin pump, a CGM, and a control algorithm/software analyzing CGM data and both predicting and adjusting insulin infusion to mimic the function of the pancreas. Compared with standard therapy modalities, AID systems can improve time-in-range and reduce HbA1c levels, time in hypo- and hyperglycemia, and hypo- and hyperglycemic events. Owing to these benefits, AID systems may improve health-related quality-of-life and reduce the incidence of long-term diabetes-related complications. It is unclear if these beneficial effects offset this technology’s higher acquisition costs, and it is important to determine if AID systems provide good value for money compared with standard therapy. This project is assessing the long-term cost-effectiveness of AID systems versus standard therapy among individuals with T1D from the US healthcare system/payer perspective to determine if the cost of AID systems are offset by improved health-related quality-of-life and reduced diabetes-related complications.
Supporting, Maintaining and Improving the Surveillance System for Chronic Kidney Disease in the U.S. - The goal of this project is to obtain and analyze high-value Federal and non-Federal data related to chronic kidney disease ICKD) and to integrate it into the CDC’s National Diabetes Surveillance System. The core goal/purpose of this project is to maintain, regularly update, and enhance the existing CDC-CKD surveillance web application on CDC’s information technology platform.
Diabetes, diabetes complications, diabetes epidemiology, health services research, and health economics
Research Projects:
Population health impact of a self-insured employer's policy change to cover weight reduction and diabetes prevention interventions for employees, dependents, and retirees with prediabetes. - In September 2015, the University of Michigan changed its healthcare benefits to cover interventions for weight reduction and diabetes prevention at no out-of-pocket cost. We evaluated the impact of this large-scale policy change on population health by first comparing the yield of three strategies used to identify nondiabetic employees, dependents, and retirees with prediabetes. We also evaluated the incremental benefits of engaging primary care physicians in case finding and referral. Second, we described intervention uptake and reach and assessed individual preferences for in-person and internet-based lifestyle interventions and for metformin therapy. We explained intervention participation based on the Health Belief Model, and further described and compared the uptake, adherence, retention, and change in outcomes (weight, BMI, HbA1c, and quality-of-life) associated with each intervention. Currently, we are modeling the effectiveness, costs, and cost-utility of the interventions relative to no intervention over one and two years. The results of the evaluation will have major implications for benefit design, health policy, and population health.
Real-world effectiveness of structured lifestyle interventions in preventing type 2 diabetes. - In this multicenter project, we are further assessing individual and system-level barriers to and facilitators of participation in the National Diabetes Prevention Program (DPP)/Medicare DPP and evaluating the long-term (5-year) effectiveness and cost-effectiveness of the DPP as implemented in real-world settings. By assessing individual and system level barriers to and facilitators of participation in the DPP, and by evaluating the long-term effectiveness and cost-effectiveness of the DPP as implemented in real-world settings, this study will provide information critical to improving the uptake and impact of the DPP on diabetes in the United States.
The Glycemia Reduction Approaches for Diabetes: A Comparative Effectiveness Study (GRADE) Economic Analysis. - GRADE assessed the comparative effectiveness, safety, and tolerability of four antidiabetic medications with different glucose lowering mechanisms when used in conjunction with metformin to determine which strategy best improves glycemic control over time. We served as a clinical site to recruit, enroll, and retain ~150 patients. We are currently leading the GRADE economic analysis. It assumes that the four treatments differ in their efficacy, cost, and quality-of-life impact. The primary analysis is being performed using an intention-to-treat approach. Participants’ data are being analyzed according to their randomized treatment group whether or not they adhere to their assigned treatment. A sensitivity analysis will be conducted using a “per-protocol” approach. In the per-protocol analysis, outcomes will be assessed by treatment group only for participants who adhered to their randomized treatment and/or responded to their treatment at predefined time points following randomization.
Economic analysis of automated insulin delivery (AID) systems. - Good glycemic control is critical to reduce the incidence of the long-term complications of diabetes. Over the past three decades, evidence has shown that intensive insulin therapy using multiple daily injections (MDI) of insulin and continuous subcutaneous insulin infusion using insulin pumps reduce HbA1c levels and are associated with improved long-term health outcomes for people with type 1 diabetes (T1D). However, the benefits of glycemic control using intensive insulin therapy must be balanced against the risk of hypoglycemia. Recent technological advances have led to the development of sensor-driven devices that use continuous glucose monitoring (CGM) data to adjust insulin infusion automatically. Such automated insulin delivery (AID) systems which are called artificial pancreas (AP) or closed-loop control (CLC) systems combines an insulin pump, a CGM, and a control algorithm/software analyzing CGM data and both predicting and adjusting insulin infusion to mimic the function of the pancreas. Compared with standard therapy modalities, AID systems can improve time-in-range and reduce HbA1c levels, time in hypo- and hyperglycemia, and hypo- and hyperglycemic events. Owing to these benefits, AID systems may improve health-related quality-of-life and reduce the incidence of long-term diabetes-related complications. It is unclear if these beneficial effects offset this technology’s higher acquisition costs, and it is important to determine if AID systems provide good value for money compared with standard therapy. This project is assessing the long-term cost-effectiveness of AID systems versus standard therapy among individuals with T1D from the US healthcare system/payer perspective to determine if the cost of AID systems are offset by improved health-related quality-of-life and reduced diabetes-related complications.
Supporting, Maintaining and Improving the Surveillance System for Chronic Kidney Disease in the U.S. - The goal of this project is to obtain and analyze high-value Federal and non-Federal data related to chronic kidney disease ICKD) and to integrate it into the CDC’s National Diabetes Surveillance System. The core goal/purpose of this project is to maintain, regularly update, and enhance the existing CDC-CKD surveillance web application on CDC’s information technology platform.
Casagrande SS, McEwen LN, Herman WH. Changes in Health Insurance Coverage under the Affordable Care Act: a National Sample
of U.S. Adults with Diabetes, 2009 and 2016. Diabetes Care 2018;41: 956-962.
Cefalu WT, Dawes DE, Gavlak G, Goldman D, Herman WH, Van Nuys K, Powers AC, Taylor SI, Yatvin AL, on behalf of the Insulin Access and Affordability Working Group. Insulin Access and Affordability Working Group: Conclusions and Recommendations. Diabetes Care 2018;41:1299-1311.
Herman WH, Braffett B, Kuo S, Lee J, Brandle M, Jacobson A, Prosser L, Lachin J. What are the Clinical, Quality-of-Life, and Cost Consequences of 30 Years of Excellent vs. Poor Glycemic Control in Type 1 Diabetes? J Diabetes Complications 2018;32:911-915.
Tran-Duy A, Knight J, Palmer AJ, Petrie D, Lung TWC, Herman WH, Eliasson B, Svensson AM, Clarke PM. A Patient-Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes. Diabetes Care 2020;43:1741-1749.
Herman WH, Joiner K, Hurst T, McEwen LN. The Effectiveness of a Proactive, Three-level Strategy to Identify People with Prediabetes in a Large Workforce with Employer-sponsored Health Insurance. Diabetes Care 2021;44:1532-1539.
National Clinical Care Commission. Report to Congress on Leveraging Federal Programs to Prevent and Control Diabetes and Its Complications. 2021. (https://health.gov/about-odphp/committees-workgroups/national-clinical-care-commission/report-congress).
Cefalu WT, Dawes DE, Gavlak G, Goldman D, Herman WH, Van Nuys K, Powers AC, Taylor SI, Yatvin AL, on behalf of the Insulin Access and Affordability Working Group. Insulin Access and Affordability Working Group: Conclusions and Recommendations. Diabetes Care 2018;41:1299-1311.
Herman WH, Braffett B, Kuo S, Lee J, Brandle M, Jacobson A, Prosser L, Lachin J. What are the Clinical, Quality-of-Life, and Cost Consequences of 30 Years of Excellent vs. Poor Glycemic Control in Type 1 Diabetes? J Diabetes Complications 2018;32:911-915.
Tran-Duy A, Knight J, Palmer AJ, Petrie D, Lung TWC, Herman WH, Eliasson B, Svensson AM, Clarke PM. A Patient-Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes. Diabetes Care 2020;43:1741-1749.
Herman WH, Joiner K, Hurst T, McEwen LN. The Effectiveness of a Proactive, Three-level Strategy to Identify People with Prediabetes in a Large Workforce with Employer-sponsored Health Insurance. Diabetes Care 2021;44:1532-1539.
National Clinical Care Commission. Report to Congress on Leveraging Federal Programs to Prevent and Control Diabetes and Its Complications. 2021. (https://health.gov/about-odphp/committees-workgroups/national-clinical-care-commission/report-congress).
Email: [email protected]
Office: 734-936-8279
Fax: 734-647-2307
Address:
Room 6108 Brehm Tower
1000 Wall Street
Ann Arbor, Michigan 48105
Office: 734-936-8279
Fax: 734-647-2307
Address:
Room 6108 Brehm Tower
1000 Wall Street
Ann Arbor, Michigan 48105
Areas of Expertise: Diabetes, Health Economics