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

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 $1,403 ($1,077 of African American men and $1,532 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.

Leveraging data and digital health technologies to assess and impact social determinants of health (SDoH)

“…Demographic factors (e.g., identity and economic) are more easily and frequently collected than more actionable factors. However, interventions for behavioral-related SDoH factors are more feasible and have demonstrated examples of high ROI (ROI range, $7.60 to $16.70 returned for every US dollar spent) to promote healthy eating and weight loss [39,40]. Policy recommendations [8,17] to prioritize other actionable SDoH factors such as education, food, and housing in targeted interventions show reduced costs [41][42][43].…”

Sustaining the reach of a scalable weight loss intervention through financial incentives- a pragmatic, feasibility, online randomized trial protocol

“…The secondary outcomes include absolute weight loss achieved at 3, 6, 9, and 12 months, respectively, and the percent of participants achieving clinically significant weight loss (≥3%, ≥5%, or ≥7% of the initial bodyweight). Additionally, we will collect intervention cost data using all program invoices related to program implementation and further grouped into technical systems support, program delivery personnel, kiosk leasing, marketing personnel and activities, and program incentives as categorized in our previous cost-effectiveness assessment of the program [34].…”

A Systematic Review of Methods to Predict Weight Trajectories in Health Economic Models of Behavioral Weight-Management Programs: The Potential Role of Psychosocial Factors

“…Weight loss regained immediately. Eight HEMs [35][36][37][38][39][40][41][42] assumed that the intervention effect ceased after the trial follow-up and that those receiving the intervention immediately returned to the same weight as the control group. From this point onward, there was no weight difference between the intervention and control groups; their weight either remained at that value for the remainder of the time horizon [35][36][37][38][39]42 or followed a natural history trajectory 40,41 (Figure 2b).…”

“…Thirty HEMs cited an evidence source for estimated weight loss that reported no measurement of psychosocial variables. [24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40]42,44,46,[49][50][51][52]55,56,58,59,61,62,68 Psychosocial variables were measured in evidence sources cited in 8 HEMs (Table 3); 4 of these HEMs 43,45,48,53 each based the estimated weight loss on a single trial, but no analyses of the psychosocial variables measured in relation to the intervention or weight change were reported in the trial. Four HEMs 23,34,41,47 cited 5 trials that included some analysis of psychosocial factors.…”