Can Early Childhood Obesity Prevention be Cost-Effective in the Short Term?

Alison J Hayes, Eng Joo Tan

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Background: There is global interest in the benefits of early childhood obesity prevention. A Cochrane systematic review has shown a significant but small overall effect in children under 5 years but provided no information on cost-effectiveness nor the costs of intervention delivery. We have developed an individual–level model – the Early Prevention of Obesity in Childhood (EPOCH) model to project BMI, QALYs and direct healthcare costs from early childhood to late adolescence. The model is informed by Australian population representative data on children, systematic reviews and other published literature.
Objective: To use the EPOCH model and intervention effect sizes determined from a systematic review, to project expected health benefits (QALYs and BMI reduction) and healthcare cost-savings accruing until late adolescence. Secondly, to determine the range of intervention costs per child for ICERS to be within standard cost/QALY thresholds.

Data and Methods: The base case (control) scenario was modelled using data from children aged 4/5 years from an Australian population representative survey, the Longitudinal Study of Australian Children(LSAC). The average intervention effect size of 0.26kg/m2from a Cochrane review of interventions for preventing obesity in children (aged 0-5 years) was applied to the LSAC data, using a distribution shift method. The intervention effect was reflected only through the two base populations – intervention and control. Using the EPOCH model, ICERS were calculated over 5 and 10 years, for a range of intervention costs ranging from $AUD100 to $AUD2000. Costs and effects were discounted to net present values. We determined the probability of being cost-effective at a threshold of $AUD50,000/QALY for each intervention delivery cost and over two time horizons (5 and 10 years).

Results: At age 10 years incremental BMI and incremental QALYs were 0.32 kg/m2and 0.009 units. At 15 years incremental BMI and QALYs were 0.35 kg/m2and 0.0140 units. The model predicted some cost offsets due to savings in direct healthcare costs as a result of the intervention. Over the 5-year time horizon, an intervention that produced a difference in BMI of 0.26 units at age 4 years had a greater than 90% probability of being cost-effective for interventions costing up to AUD$400 (US$249). Considering the 10-year time horizon, the same intervention effect size had a greater than 90% probability of being cost-effective for interventions costing up to AUD$660 (US$412). Interventions costing more than $1100 for this effect size were extremely unlikely to be cost-effective. Whilst the EPOCH model also predicted incremental BMI, willingness to pay per unit BMI has not been established -thus cost-effectiveness based on BMI could not be determined.

Conclusion: Based on effect sizes from the Cochrane review, obesity prevention in early childhood can be cost-effective provided intervention delivery costs per child are modest. These are important considerations in the design of early childhood obesity prevention programmes. Cost-effectiveness improved with extended time horizon – an important message for policy makers. Willingness to pay studies for BMI reduction would greatly enhance the ability to interpret cost-effectiveness ratios based on incremental cost/BMI unit saved.
Original languageEnglish
Pages142
Number of pages1
Publication statusPublished - 15 Jul 2019
Externally publishedYes
EventiHEA World Congress on Health Economics 2019 - Basel, Switzerland
Duration: 13 Jul 201917 Jul 2019
https://healtheconomics.org/congress/
https://www.healtheconomics.org/wp-content/uploads/2022/07/2019-abstract_book.pdf

Conference

ConferenceiHEA World Congress on Health Economics 2019
Abbreviated titleiHEA 2019
Country/TerritorySwitzerland
CityBasel
Period13/07/1917/07/19
Internet address

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