Research
The cost-effectiveness of a school-based overweight program
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* Corresponding author: Henry Shelton Brown henry.s.brown@uth.tmc.edu
1 Division of Management, Policy and Community Health, University of Texas School of Public Health, Austin, TX 78701, USA
2 Department of Bioinformatics and Biostatistics School of Public Health and Information Sciences University of Louisville 555 S. Floyd Street, Suite 4026 Louisville, KY 40292, USA
3 Division of Biostatistics, University of Texas School of Public Health, Houston, TX 77225, USA
4 Division of Behavioral Science, University of Texas School of Public Health, Austin, TX 78701, USA
5 Division of Epidemiology, University of Texas School of Public Health, Austin, TX 78701, USA
6 Valley Baptist Hospital, Harlingen, TX 78520, USA
7 Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health, Austin, TX 78701, USA
International Journal of Behavioral Nutrition and Physical Activity 2007, 4:47 doi:10.1186/1479-5868-4-47
Published: 1 October 2007Abstract
Background
This study assesses the net benefit and the cost-effectiveness of the Coordinated Approach to Child Health (CATCH) intervention program, using parameter estimates from the El Paso trial. There were two standard economic measures used. First, from a societal perspective on costs, cost-effectiveness ratios (CER) were estimated, revealing the intervention costs per quality-adjusted life years (QALYs) saved. QALY weights were estimated using National Health Interview Survey (NHIS) data. Second, the net benefit (NB) of CATCH was estimated, which compared the present value of averted future costs with the cost of the CATCH intervention. Using National Health and Nutrition Examination Survey I (NHANES) and NHANES follow-up data, we predicted the number of adult obesity cases avoided for ages 40–64 with a lifetime obesity progression model.
Results
The results show that CATCH is cost-effective and net beneficial. The CER was US$900 (US$903 using Hispanic parameters) and the NB was US$68,125 (US$43,239 using Hispanic parameters), all in 2004 dollars. This is much lower than the benchmark for CER of US$30,000 and higher than the NB of US$0. Both were robust to sensitivity analyses.
Conclusion
Childhood school-based programs such as CATCH are beneficial investments. Both NB and CER declined when Hispanic parameters were included, primarily due to the lower wages earned by Hispanics. However, both NB and CER for Hispanics were well within standard cost-effectiveness and net benefit thresholds.