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

Moodie, M., Haby, M., Wake, M., Gold, L. and Carter, R. 2008, Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children, Economics and human biology, vol. 6, no. 3, pp. 363-376.

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Title Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children
Author(s) Moodie, M.
Haby, M.
Wake, M.
Gold, L.
Carter, R.
Journal name Economics and human biology
Volume number 6
Issue number 3
Start page 363
End page 376
Total pages 14
Publisher Elsevier BV
Place of publication Amsterdam, The Netherlands
Publication date 2008-12
ISSN 1570-677X
1873-6130
Keyword(s) children
overweight
general practitioners
family-based
Summary 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.
Language eng
Field of Research 110706 Immunogenetics (incl Genetic Immunology)
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
HERDC collection year 2008
Copyright notice ©2008, Elsevier B.V.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30017351

Document type: Journal Article
Collection: Public Health Research, Evaluation, and Policy Cluster
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