Development and implementation cost analysis of telephone- and Internet-based interventions for the maintenance of weight loss.
OBJECTIVE
The Weight Loss Maintenance Trial (WLM) was a multicenter, randomized trial comparing two weight loss maintenance interventions, a personal contact (PC) program with primarily telephone-based monthly contacts, and an Internet-based program (interactive technology, IT), to a self-directed control group, among overweight or obese individuals at high cardiovascular risk. This study describes implementation costs of both interventions as well as IT development costs.


METHODS
Resources were micro-costed in 2006 dollars from the primary perspective of a sponsoring healthcare system considering adopting an extant intervention, rather than developing its own. Costs were discounted at 3 percent annually. Length of trial participation was 30 months (randomization during February-November 2004). IT development costs were assessed over 36 months. Univariate and multivariate, including probabilistic, sensitivity analyses were performed.


RESULTS
Total discounted IT development costs over 36 months were $839,949 ($2,414 per IT participant). Discounted 30-month implementation costs for 342 PC participants were $537,242 ($1,571 per participant), and for 348 IT participants, were $214,879 ($617 per participant). Under all plausible scenarios, PC implementation costs exceeded IT implementation costs.


CONCLUSIONS
Costs of implementing and operating an Internet-based intervention for weight loss maintenance were substantially less than analogous costs of an intervention using standard phone and in-person contacts and are of a magnitude that would be attractive to many health systems, subject to demonstration of cost-effectiveness.
Meenan
Richard T
RT
Kaiser Permanente Center for Health Research, Portland, Oregon 97227, USA. richard.meenan@kpchr.org
Stevens
Victor J
VJ
Funk
Kristine
K
Bauck
Alan
A
Jerome
Gerald J
GJ
Lien
Lillian F
LF
Appel
Lawrence
L
Hollis
Jack F
JF
Brantley
Phillip J
PJ
Svetkey
Laura P
LP
D003365:Costs and Cost Analysis; D006801:Humans; D020407:Internet / Q000191:economics*; D009042:Motivation; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D020377:Self Efficacy; D013689:Telephone / Q000191:economics*; D015431:Weight Loss