TY - JOUR
T1 - Cost-effectiveness of community-based childhood obesity prevention interventions in Australia
AU - Ananthapavan, Jaithri
AU - Nguyen, Phuong K.
AU - Bowe, Steven J.
AU - Sacks, Gary
AU - Mantilla Herrera, Ana Maria
AU - Swinburn, Boyd Anthony
AU - Brown, Vicki
AU - Sweeney, Rohan
AU - Lal, Anita
AU - Strugnell, Claudia
AU - Moodie, Marj
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Objectives: The objective of this study is to examine, from a limited societal perspective, the cost-effectiveness of community-based obesity prevention interventions (CBIs)-defined as a programme of community-level strategies to promote healthy eating and physical activity for Australian children (aged 5–18 years). Methods: The effectiveness of CBIs was determined by undertaking a literature review and meta-analysis. Commonly implemented strategies to increase physical activity and improve nutrition were costed (in 2010 Australian dollars) to determine the average cost of a generic programme. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the lifetime of the target population. Monte-Carlo simulation was used to assess second-order uncertainty of input parameters to estimate mean incremental cost-effectiveness ratios (ICER) with 95% uncertainty intervals (UIs). Scenario analyses tested variations in programme intensity, target population, and duration of effect. Results: The meta-analysis revealed a small but significant difference in BMI z-score (mean difference of − 0.07 (95% UI: − 0.13 to − 0.01)) favouring the CBI community compared with the control. The estimated net cost of implementing CBIs across all local government areas (LGAs) in Australia was AUD426M (95% UI: AUD3M to AUD823M) over 3 years. This resulted in 51,792 HALYs gained (95% UI: 6816 to 96,972) over the lifetime of the cohort. The mean ICER was AUD8155 per HALY gained (95% UI: AUD237 to AUD81,021), with a 95% probability of being cost-effective at a willingness to pay threshold of AUD50,000 per HALY. Conclusions: CBIs are cost-effective obesity prevention initiatives; however, implementation across Australia will be (relatively) expensive when compared with current investments in preventive health.
AB - Objectives: The objective of this study is to examine, from a limited societal perspective, the cost-effectiveness of community-based obesity prevention interventions (CBIs)-defined as a programme of community-level strategies to promote healthy eating and physical activity for Australian children (aged 5–18 years). Methods: The effectiveness of CBIs was determined by undertaking a literature review and meta-analysis. Commonly implemented strategies to increase physical activity and improve nutrition were costed (in 2010 Australian dollars) to determine the average cost of a generic programme. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the lifetime of the target population. Monte-Carlo simulation was used to assess second-order uncertainty of input parameters to estimate mean incremental cost-effectiveness ratios (ICER) with 95% uncertainty intervals (UIs). Scenario analyses tested variations in programme intensity, target population, and duration of effect. Results: The meta-analysis revealed a small but significant difference in BMI z-score (mean difference of − 0.07 (95% UI: − 0.13 to − 0.01)) favouring the CBI community compared with the control. The estimated net cost of implementing CBIs across all local government areas (LGAs) in Australia was AUD426M (95% UI: AUD3M to AUD823M) over 3 years. This resulted in 51,792 HALYs gained (95% UI: 6816 to 96,972) over the lifetime of the cohort. The mean ICER was AUD8155 per HALY gained (95% UI: AUD237 to AUD81,021), with a 95% probability of being cost-effective at a willingness to pay threshold of AUD50,000 per HALY. Conclusions: CBIs are cost-effective obesity prevention initiatives; however, implementation across Australia will be (relatively) expensive when compared with current investments in preventive health.
UR - http://www.scopus.com/inward/record.url?scp=85063909529&partnerID=8YFLogxK
U2 - 10.1038/s41366-019-0341-0
DO - 10.1038/s41366-019-0341-0
M3 - Article
C2 - 30926947
AN - SCOPUS:85063909529
SN - 0307-0565
VL - 43
SP - 1102
EP - 1112
JO - International Journal of Obesity
JF - International Journal of Obesity
IS - 5
ER -