Cost-effectiveness of WISEWOMAN, a program aimed at reducing heart disease risk among low-income women.
OBJECTIVE
To quantify the cost-effectiveness of the WISEWOMAN program. WISEWOMAN is a Centers for Disease Control and Prevention (CDC)-funded lifestyle intervention program that provides low-income uninsured women aged 40-64 with chronic disease risk factor screenings, lifestyle interventions, and referral services in an effort to prevent coronary heart disease (CHD) and improve health.


METHODS
We used data for 3015 WISEWOMAN participants who completed baseline and 1-year follow-up screenings. We quantified the average per capita cost of providing WISEWOMAN over the last 6 months of the reporting period. We assessed 1-year reductions in select CHD risk factors. We calculated the cost-effectiveness ratio by dividing the average per capita cost by average predicted life-years gained.


RESULTS
The cost of providing WISEWOMAN services to each additional participant averaged 270 US dollars per participant. Participants significantly improved their systolic (1.3%) and diastolic (1.7%) blood pressure, total (2%) and high-density lipoprotein (HDL) (0.7%) cholesterol, and 10-year risk of CHD (8.7%). There were also significant reductions in percent of women who smoked (11.7%) or had high blood pressure (15.8%) or high cholesterol (13.1%). The bestcase cost-effectiveness ratio was 470 US dollars per percentage point reduction in CHD risk, or 4400 US dollars per discounted life-year gained; however, sensitivity analysis revealed substantial uncertainty around this estimate.


CONCLUSIONS
Although more research is needed to confirm the assumptions used in the model, results of our analysis suggest that the WISEWOMAN program is a cost-effective approach for reducing CVD risk among low-income, uninsured women aged 40-64, especially if improvements in risk factors are sustainable when program participation concludes.
Finkelstein
Eric A
EA
RTI International, Health, Social, and Economics Research, Research Triangle Park, North Carolina 27709, USA. finkelse@rti.org
Khavjou
Olga
O
Will
Julie C
JC
D002318:Cardiovascular Diseases / Q000191:economics* / Q000517:prevention & control*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006302:Health Services Research; D006801:Humans; D008019:Life Style; D008404:Massachusetts; D017057:Medically Uninsured; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011203:Poverty; D011314:Preventive Health Services / Q000191:economics* / Q000592:standards; D015397:Program Evaluation; D014481:United States; D016387:Women's Health / Q000191:economics*; D014932:Women's Health Services / Q000191:economics* / Q000592:standards