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Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children

Author

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  • Moodie, Marjory
  • Haby, Michelle
  • Wake, Melissa
  • Gold, Lisa
  • Carter, Robert

Abstract

Objective To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children. The intervention was modelled on the LEAP (live, eat and play) trial, a randomised controlled trial conducted by the Centre for Community Child Health, Melbourne, Australia in 2002-2003. This study was undertaken as part of the assessing cost-effectiveness (ACE) in obesity project which evaluated, using consistent methods, 13 interventions targeting unhealthy weight gain in children and adolescents.Method A logic pathway was used to model the effects of the intervention compared to no intervention on body mass index (BMI) and health outcomes (disability-adjusted life years--DALYs). Disease costs and health benefits were tracked until the cohort of eligible children reached the age of 100 years or death. Simulation-modelling techniques were used to present a 95% uncertainty interval around the cost-effectiveness ratio. The intervention was also assessed against a series of filters ([`]equity', [`]strength of evidence', [`]acceptability', [`]feasibility', sustainability' and [`]side-effects') to incorporate additional factors that impact on resource allocation decisions.Results The intervention, as modelled, reached 9685 children aged 5-9 years with a BMI z-score of >=3.0, and cost $AUD6.3M (or $AUD4.8M excluding time costs). It resulted in an incremental saving of 2300 BMI units which translated to 511 DALYs. The cost-offsets stemming from the intervention totalled $AUD3.6M, resulting in a net cost per DALY saved of $AUD4670 (dominated; $0.1M) (dominated means intervention costs more for less effect).Conclusion Compared to a [`]no intervention' control group, the intervention was cost-effective under current assumptions, although the uncertainty intervals were wide. A key question related to the long-term sustainability of the small incremental weight loss reported, based on the 9-month follow-up results for LEAP.

Suggested Citation

  • Moodie, Marjory & Haby, Michelle & Wake, Melissa & Gold, Lisa & Carter, Robert, 2008. "Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children," Economics & Human Biology, Elsevier, vol. 6(3), pages 363-376, December.
    • Handle: RePEc:eee:ehbiol:v:6:y:2008:i:3:p:363-376
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    References listed on IDEAS

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    1. Robert C. Whitaker, "undated". "Obesity Prevention in Pediatric Primary Care: Four Behaviors to Target," Mathematica Policy Research Reports fb2a2ffd7d024ffa943e512c4, Mathematica Policy Research.
    2. repec:mpr:mprres:3649 is not listed on IDEAS
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    1. Greve, Jane & Heinesen, Eskil, 2015. "Evaluating the impact of a school-based health intervention using a randomized field experiment," Economics & Human Biology, Elsevier, vol. 18(C), pages 41-56.
    2. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    3. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Management of Dementia Patients - A Systematic Literature Review," Working Papers 2018:41, Lund University, Department of Economics.
    4. Buchmueller, Thomas C. & Johar, Meliyanni, 2015. "Obesity and health expenditures: Evidence from Australia," Economics & Human Biology, Elsevier, vol. 17(C), pages 42-58.
    5. Jørgen Dejgård Jensen & Henrik Saxe & Sigrid Denver, 2015. "Cost-Effectiveness of a New Nordic Diet as a Strategy for Health Promotion," IJERPH, MDPI, vol. 12(7), pages 1-22, June.
    6. Sanjib Saha & Ulf-G Gerdtham & Pia Johansson, 2010. "Economic Evaluation of Lifestyle Interventions for Preventing Diabetes and Cardiovascular Diseases," IJERPH, MDPI, vol. 7(8), pages 1-46, August.
    7. Batscheider, Ariane & Rzehak, Peter & Teuner, Christina M. & Wolfenstetter, Silke B. & Leidl, Reiner & von Berg, Andrea & Berdel, Dietrich & Hoffmann, Barbara & Heinrich, Joachim, 2014. "Development of BMI values of German children and their healthcare costs," Economics & Human Biology, Elsevier, vol. 12(C), pages 56-66.
    8. Lisa Arai & Monica Panca & Steve Morris & Katherine Curtis-Tyler & Patricia J Lucas & Helen M Roberts, 2015. "Time, Monetary and Other Costs of Participation in Family-Based Child Weight Management Interventions: Qualitative and Systematic Review Evidence," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-12, April.
    9. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    10. Mora, Toni & Llargués, Esteve & Recasens, Assumpta, 2015. "Does health education affect BMI? Evidence from a school-based randomised-control trial," Economics & Human Biology, Elsevier, vol. 17(C), pages 190-201.
    11. Nora Döring & Susanne Mayer & Finn Rasmussen & Diana Sonntag, 2016. "Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations," IJERPH, MDPI, vol. 13(9), pages 1-11, September.
    12. Joanne Castonguay, 2012. "Revue de littérature sur les études économiques des interventions auprès des enfants obèses," CIRANO Project Reports 2012rp-15, CIRANO.
    13. Mandana Zanganeh & Peymane Adab & Bai Li & Emma Frew, 2019. "A Systematic Review of Methods, Study Quality, and Results of Economic Evaluation for Childhood and Adolescent Obesity Intervention," IJERPH, MDPI, vol. 16(3), pages 1-14, February.
    14. Yong Yi Lee & J Lennert Veerman & Jan J Barendregt, 2013. "The Cost-Effectiveness of Laparoscopic Adjustable Gastric Banding in the Morbidly Obese Adult Population of Australia," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-10, May.
    15. Linda J Cobiac & Theo Vos & J Lennert Veerman, 2010. "Cost-Effectiveness of Interventions to Promote Fruit and Vegetable Consumption," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-8, November.
    16. Jaithri Ananthapavan & Gary Sacks & Marj Moodie & Rob Carter, 2014. "Economics of Obesity — Learning from the Past to Contribute to a Better Future," IJERPH, MDPI, vol. 11(4), pages 1-19, April.

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