Cost-effectiveness of a lifestyle intervention improving physical activity and nutritional behaviour from different economic perspectives

Abstract

Background Combined lifestyle interventions to improve physical activity and nutritional behaviour show positive health effects in adults with overweight and obesity. To reveal the impact of different perspectives in economic evaluations, we present the cost-effectiveness of two different intensities of a combined lifestyle intervention from both societal and healthcare perspective with a time horizon of 24 months. Methods In a clustered RCT (29 clusters, n=411) we studied the cost-effectiveness of a start-up program versus a more intensively supervised program During two years every three months quality of life and costs (healthcare, productivity, patient and family) were assessed by means of self-administered questionnaires. Uncertainty was assessed by means of bootstrap and sensitivity analyses. Findings Baseline characteristics were comparable between the groups. After one year, the supervised program showed higher programme costs but less healthcare utilization resulting in only slightly higher total costs. Moreover the supervised program showed higher one-year and two-year QALYs compared to the start-up program. Discussion After 1 year the supervised program is cost-effective from a healthcare perspective, though other perspectives and different time horizons affect the outcomes.