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Prev Med. 2017 Dec;105:295-303. doi: 10.1016/j.ypmed.2017.10.011. Epub 2017 Oct 5.

Cost effectiveness and return on investment of a scalable community weight loss intervention.

Author information

1
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: tzeyu.michaud@unmc.edu.
2
Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, USA.
3
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
4
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
5
incentaHEALTH, LLC, Denver, CO, USA.
6
Prevention and Chronic Care Solutions, Kaiser Permanente Colorado, Denver, CO, USA.

Abstract

This study assessed the lifetime health and economic consequences of an efficacious scalable community weight loss program for overweight and obese adults. We applied a state-transition Markov model to project lifetime economic outcome (US dollar) and the degree of disease averted as a result of a weight loss intervention, compared with no intervention, from a payer perspective. Effect sizes of the intervention on weight loss, by sex, race and ethnicity, and body mass index (BMI) of participants, were derived from a 12-month community program. Relative risk of diseases across BMI levels and other parameters were informed by the literature. A return on investment (ROI) analysis was conducted to present the overall cost-benefit of the program. Simulation results showed that among 33,656 participants and at a cost of $2.88 million, the program was predicted to avert (with a corresponding estimated medical costs saved of) 78 cases of coronary heart disease ($28 million), 9 cases of strokes ($971,832), 92 cases of type 2 diabetes ($24 million), 1 case of colorectal cancer ($357,022), and 3 cases of breast cancer ($483,259) over the participant lifetime. The estimated medical costs saved per participant was $1403 ($1077 of African American men and $1532 of Hispanic men), and the ROI was $16.7 ($12.8 for African American men and $18.3 for Hispanic men) for every $1 invested. We concluded that a scalable efficacious community weight loss program provides a cost-effective approach with significant ROI, which will assist informed decisions for future adoption and dissemination.

KEYWORDS:

Cost; Internet intervention; Obesity; Public health

PMID:
28987334
PMCID:
PMC5918290
DOI:
10.1016/j.ypmed.2017.10.011
[Indexed for MEDLINE]
Free PMC Article

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