Modelling the lifetime costs and health effects of lifestyle intervention in the prevention and treatment of obesity in Switzerland.
OBJECTIVE
To quantify the lifetime health and economic consequences of preventing and treating obesity with lifestyle intervention in Switzerland.


METHODS
A Markov model was developed comparing lifestyle intervention and standard care in overweight and obese people. Changes in weight and cardiovascular risk factors over time were modeled from reduction in body mass index, systolic blood pressure, total cholesterol and high density lipoprotein in three-year active treatment period. A probabilistic sensitivity analysis was performed. Three groups of people were followed in the analysis: overweight, borderline and moderate obese. The cost-effectiveness of interventions was compared using incremental cost-effectiveness ratio.


RESULTS
Lifestyle intervention resulted in increased survival duration and quality of life over lifetime. Compared with standard care, the average incremental cost of lifestyle intervention was lower in borderline and obese and higher in overweight. Lifestyle intervention dominated standard care in borderline female age 35 to 55 years, borderline male age 25 to 60 years, obese female age 45 years and obese male age 55 years.


CONCLUSIONS
Our economic analysis suggests that lifestyle intervention is cost-effective in the long-term prevention and treatment of obesity.
Galani
Carmen
C
HealthEcon AG, Basel, Switzerland. cgalani@healthecon.com
Schneider
Heinz
H
Rutten
Frans F H
FF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D050177:Overweight; D011788:Quality of Life; D012307:Risk Factors; D013557:Switzerland; D013997:Time Factors
D008075:Lipoproteins, HDL; D002784:Cholesterol