Format

Send to

Choose Destination
Prev Med. 2019 Jul;124:42-49. doi: 10.1016/j.ypmed.2019.04.011. Epub 2019 Apr 16.

Economic evaluation of California prenatal participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) to prevent preterm birth.

Author information

1
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095, USA; California Center for Population Research, UCLA, Los Angeles, CA, USA. Electronic address: niaroch@ucla.edu.
2
California Center for Population Research, UCLA, Los Angeles, CA, USA; Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA.
3
Chief Information Office, County of Los Angeles, Los Angeles, CA, USA.
4
California Center for Population Research, UCLA, Los Angeles, CA, USA; Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA; Research and Evaluation Unit, Public Health Foundation Enterprises- Special Supplemental Nutrition Program for Women, Infants and Children (PHFE WIC), 12781 Schabarum Ave., Irwindale, CA 91706.
5
Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA.
6
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095, USA; California Center for Population Research, UCLA, Los Angeles, CA, USA; UCLA Center for Health Policy Research, Los Angeles, CA, USA.
7
Research and Evaluation Unit, Public Health Foundation Enterprises- Special Supplemental Nutrition Program for Women, Infants and Children (PHFE WIC), 12781 Schabarum Ave., Irwindale, CA 91706.

Abstract

There is growing evidence that prenatal participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) reduces the risk of adverse birth outcomes. With recent changes in health care, rising health care costs, and increasing rates of prematurity in the U.S., there is urgency to estimate the potential cost savings associated with prenatal WIC participation. A cost-benefit analysis from a societal perspective with a time horizon over the newborn's life course for a hypothetical cohort of 500,000 Californian pregnant women was conducted in 2017. A universal coverage, a status quo ('business as usual') and a reference scenario (absence of WIC) were compared. Total societal costs, incremental cost savings, return on investment, number of preterm births prevented, and incremental net monetary benefits were reported. WIC resulted in cost-savings of about $349 million and the prevention of 7575 preterm births and would save more if it were universal. Spending $1 on prenatal WIC resulted in mean savings of $2.48 (range: $1.24 to $6.83). Decreasing prenatal WIC enrollment by 10% would incur additional costs (i.e. loss) of about $45.3 million to treat the resulting 981 preterm babies. In contrast, a 10% increase in prenatal WIC enrollment would prevent 141 preterm births and achieve additional cost-savings of $6.5 million. The findings confirm evaluations from the early 1990s that prenatal WIC participation is cost-saving and cost-effective. Further savings could be achieved if all eligible women were enrolled in WIC. Substantial preterm birth-related costs would result from reductions in WIC participation.

KEYWORDS:

Birth outcomes; Cost-benefit; Cost-effectiveness; Decision model; Economic evaluation; G-computation; Hypothetical cohort; Preterm; Simulation; WIC

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center