Cost-effectiveness of LiveLighter® - a mass media public education campaign for obesity prevention

Background: The Western Australian LiveLighter® program has implemented a series of mass media advertising campaigns that aim to encourage adults to achieve and maintain a healthy weight through healthy behaviours. This study aimed to assess the cost-effectiveness of the LiveLighter® campaign in preventing obesity-related ill health in the Western Australian population from the health sector perspective. Methods: Campaign effectiveness (delivered over 12 months) was estimated from a meta-analysis of two cohort studies that surveyed a representative sample of the Western Australian population aged 25–49 years on discretionary food consumption one month pre- and one month post-campaign. Campaign costs were derived from campaign invoices and interviews with campaign staff. Long-term health (measured in health-adjusted life years (HALYs)) and healthcare cost-savings resulting from reduced obesity-related diseases were modelled over the lifetime of the population using a validated multi-state lifetable Markov model (ACE-Obesity Policy model). All cost and health outcomes were discounted at 7% and presented in 2017 values. Uncertainty analyses were undertaken using Monte-Carlo simulations. Results: The 12-month intervention was estimated to cost approximately A$2.46 million (M) (95% uncertainty interval (UI): 2.26M; 2.67M). The meta-analysis indicated post-campaign weekly reduction in sugary drinks consumption of 0.78 serves (95% UI: 0.57; 1.0) and sweet food of 0.28 serves (95% UI: 0.07; 0.48), which was modelled to result in average weight reduction of 0.58 kilograms (95%UI: 0.31; 0.92), 204 HALYs gained (95%UI: 103; 334), and healthcare cost-savings of A$3.17M (95%UI: A$1.66M; A$5.03M). The mean incremental cost-effectiveness ratio showed that LiveLighter® was dominant (cost-saving and health promoting; 95%UI: dominant; A$7 703 per HALY gained). The intervention remained cost-effective in all sensitivity analyses conducted. Conclusion: The LiveLighter® campaign is likely to represent very good value-for-money as an obesity prevention intervention in Western Australia and should be included as part of an evidence-based obesity prevention strategy.