Michaud, Tzeyu L.; You, Wen; Wilson, Kathryn E.; Su, Dejun; McGuire, Todd J.; Almeida, Fabio A.; Bayer, Amy L.; Estabrooks, Paul A. In: Preventive Medicine, Vol. 105, 01.12.2017, p. 295-303.
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.
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AUTHORS Paul A. Estabrooks, Ph.D. Department of Health Promotion, Social and Behavioral Health / University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365 USA Kathryn E. Wilson, Ph.D. Department of Health Promotion, Social and Behavioral Health / University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365 USA Todd J. McGuire, BS IncentaHealth LLC, Denver, CO, USA Samantha M. Harden, Ph.D. Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA NithyaPriya Ramalingam, BSc Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA Lia Schoepke, MBA.-HA IncentaHealth LLC, Denver, CO, USA Fabio A. Almeida, Ph.D. Department of Health Promotion, Social and Behavioral Health / University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365 USA Amy L. Bayer, MPH Kaiser Permanente Colorado, Prevention and Chronic Care Solutions, Denver, CO, USA