Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: Cost-utility analysis alongside a randomised controlled trial (the HELP trial)

Monica Panca*, Deborah Christie, Tim J. Cole, Silvia Costa, John Gregson, Rebecca Holt, Lee D. Hudson, Anthony Kessel, Sanjay Kinra, Anne Mathiot, Irwin Nazareth, Jay Wataranan, Ian Chi Kei Wong, Russell M. Viner, Stephen Morris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objective To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care. Design Cost-utility analysis alongside a randomised controlled trial. Setting Community settings in Greater London, England. Participants 174 young people with obesity aged 12-19 years. Interventions Intervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice. Main outcome measures Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC). Results Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained. Conclusions We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective. Trial registration number ISRCTN99840111.

Original languageEnglish
Article number018640
JournalBMJ Open
Volume8
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Bibliographical note

Funding Information:
Funding This work was supported by the NIHR under its Programme Grants for Applied Research programme (Grant Reference Number RP-PG-0608-10035)—the Paediatric Research in Obesity Multi-model Intervention and Service Evaluation (PROMISE) programme). The HELP research team acknowledges the support of the NIHR through the Primary Care Research Network. TJC was funded by MRC grant MR/M012069/1.

Keywords

  • childhood obesity
  • cost-effective
  • cost-utility
  • qaly

Fingerprint

Dive into the research topics of 'Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: Cost-utility analysis alongside a randomised controlled trial (the HELP trial)'. Together they form a unique fingerprint.

Cite this