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Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care.

Verhaeghe N, De Smedt D, De Maeseneer J, Maes L, Van Heeringen C, Annemans L - BMC Public Health (2014)

Bottom Line: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case.Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY).The uncertainty associated with the intervention effect had the greatest impact on the model.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Ghent University, De Pintelaan 185 9000, Ghent, Belgium. nick.verhaeghe@ugent.be.

ABSTRACT

Background: There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.

Methods: A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.

Results: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.

Conclusions: As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.

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Related in: MedlinePlus

One-way sensitivity analysis: effects on cost/QALY. (a) Men. (b) Women.
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Fig2: One-way sensitivity analysis: effects on cost/QALY. (a) Men. (b) Women.

Mentions: The results of the one-way sensitivity analyses are shown using Tornado diagrams (Figure 2a and b). From this figure it can be concluded that the model is most sensitive to the intervention effect and to the intervention cost in both men and women. Varying other input parameters had less influence on the results. The findings of the probabilistic sensitivity analysis are shown in cost-effectiveness planes (Figure 3a and b). The points to the right of the threshold line refer to a cost-effectiveness ratio less than 30,000€/QALY. Based on 10,000 simulations, 95% credible intervals (CI) could be generated. The health promotion programme resulted in an average QALY gain of 0.008 (95% CI 0.003-0.014) at an average cost of 221€ (95% CI 168€-278€) in men and in an average QALY gain of 0.007 (95% CI 0.002-0.011) at an average cost of 256€ (95% CI 201€-316€) in women. In men, an average ICER of 26,336€/QALY (95% CI 14,439-83,209€/QALY) was found, while in women the ICER was 39,094€/QALY (95% CI 21,573-120,541€/QALY).Figure 2


Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care.

Verhaeghe N, De Smedt D, De Maeseneer J, Maes L, Van Heeringen C, Annemans L - BMC Public Health (2014)

One-way sensitivity analysis: effects on cost/QALY. (a) Men. (b) Women.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150981&req=5

Fig2: One-way sensitivity analysis: effects on cost/QALY. (a) Men. (b) Women.
Mentions: The results of the one-way sensitivity analyses are shown using Tornado diagrams (Figure 2a and b). From this figure it can be concluded that the model is most sensitive to the intervention effect and to the intervention cost in both men and women. Varying other input parameters had less influence on the results. The findings of the probabilistic sensitivity analysis are shown in cost-effectiveness planes (Figure 3a and b). The points to the right of the threshold line refer to a cost-effectiveness ratio less than 30,000€/QALY. Based on 10,000 simulations, 95% credible intervals (CI) could be generated. The health promotion programme resulted in an average QALY gain of 0.008 (95% CI 0.003-0.014) at an average cost of 221€ (95% CI 168€-278€) in men and in an average QALY gain of 0.007 (95% CI 0.002-0.011) at an average cost of 256€ (95% CI 201€-316€) in women. In men, an average ICER of 26,336€/QALY (95% CI 14,439-83,209€/QALY) was found, while in women the ICER was 39,094€/QALY (95% CI 21,573-120,541€/QALY).Figure 2

Bottom Line: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case.Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY).The uncertainty associated with the intervention effect had the greatest impact on the model.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Ghent University, De Pintelaan 185 9000, Ghent, Belgium. nick.verhaeghe@ugent.be.

ABSTRACT

Background: There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.

Methods: A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.

Results: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.

Conclusions: As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.

Show MeSH
Related in: MedlinePlus