OBJECTIVE: To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated interventiontargeting 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 >or=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.
RCT Entities:
OBJECTIVE: To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obesechildren. 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 >or=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.
Authors: Steven L Gortmaker; Boyd A Swinburn; David Levy; Rob Carter; Patricia L Mabry; Diane T Finegood; Terry Huang; Tim Marsh; Marjory L Moodie Journal: Lancet Date: 2011-08-27 Impact factor: 79.321
Authors: Tim Lobstein; Rachel Jackson-Leach; Marjory L Moodie; Kevin D Hall; Steven L Gortmaker; Boyd A Swinburn; W Philip T James; Youfa Wang; Klim McPherson Journal: Lancet Date: 2015-02-19 Impact factor: 79.321
Authors: Steven L Gortmaker; Michael W Long; Stephen C Resch; Zachary J Ward; Angie L Cradock; Jessica L Barrett; Davene R Wright; Kendrin R Sonneville; Catherine M Giles; Rob C Carter; Marj L Moodie; Gary Sacks; Boyd A Swinburn; Amber Hsiao; Seanna Vine; Jan Barendregt; Theo Vos; Y Claire Wang Journal: Am J Prev Med Date: 2015-07 Impact factor: 6.604
Authors: Lisa Arai; Monica Panca; Steve Morris; Katherine Curtis-Tyler; Patricia J Lucas; Helen M Roberts Journal: PLoS One Date: 2015-04-08 Impact factor: 3.240