A naturopathic approach to the prevention of cardiovascular disease: cost-effectiveness analysis of a pragmatic multi-worksite randomized clinical trial.
OBJECTIVE
To determine the cost-effectiveness of a worksite-based naturopathic (individualized lifestyle counseling and nutritional medicine) approach to primary prevention of cardiovascular disease (CVD).


METHODS
Economic evaluation alongside a pragmatic, multi-worksite, randomized controlled trial comparing enhanced usual care (EUC; usual care plus biometric screening) to the addition of a naturopathic approach to CVD prevention (NC+EUC).


RESULTS
After 1 year, NC+EUC resulted in a net decrease of 3.3 (confidence interval: 1.7 to 4.8) percentage points in 10-year CVD event risk (number needed to treat = 30). These risk reductions came with average net study-year savings of $1138 in societal costs and $1187 in employer costs. There was no change in quality-adjusted life years across the study year.


CONCLUSIONS
A naturopathic approach to CVD primary prevention significantly reduced CVD risk over usual care plus biometric screening and reduced costs to society and employers in this multi-worksite-based study. Trial Registration clinicaltrials.gov Identifier: NCT00718796.
From the Center for Health Outcomes and Pharmacoeconomics Research (Dr Herman), University of Arizona, and the RAND Corporation, Santa Monica, Calif; Department of Research and Clinical Epidemiology (Drs Szczurko, Cooley, and Seely), Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada; and Department of Social and Administrative Pharmacy (Drs Szczurko and Cooley), University of Toronto, Toronto, Ontario, Canada.
Patricia M
PM
Herman
Orest
O
Szczurko
Kieran
K
Cooley
Dugald
D
Seely
D000328:Adult; D000368:Aged; D002170:Canada; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004035:Diet Therapy / Q000191:economics; D037001:Directive Counseling / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006293:Health Promotion / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009324:Naturopathy / Q000191:economics* / Q000379:methods; D009786:Occupational Health Services / Q000191:economics* / Q000379:methods; D011322:Primary Prevention / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D040242:Risk Reduction Behavior