|Rasu, Rafia -|
|Hunter, Christine -|
|Peterson, Alan -|
|Maruska, Heather -|
|Foreyt, John -|
Submitted to: Electronic Publication
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: April 1, 2010
Publication Date: April 1, 2010
Citation: Rasu, R.S., Hunter, C.M., Peterson, A.L., Maruska, H.M., Foreyt, J.P. 2010. Economic evaluation of an internet-based weight management program. The American Journal of Managed Care. 16(4):e98-e104. Interpretive Summary: This study evaluated the cost-effectiveness of an internet-based behavioral treatment program versus usual healthcare aimed toward managing weight among overweight US Air Force adults. The results of this study revealed greater weight loss in the internet-based intervention than with usual care. The internet option also proved more accessible than usual care for military personnel with hectic schedules. Initial costs of the internet program were higher than usual care. Overall, the outcomes indicate that an internet-based program may be an effective approach to weight management for the general population. Despite the outstanding cost of initiating a web-based intervention, it may be more cost efficient method in the long run. Positive health outcomes may surpass those attained by usual care. The flexibility and accessibility of the program better accommodates busy schedules. Decreased dependence on personal interaction with professional personnel may lend to reduced cost and greater time efficiency. Further research is required that utilizes a cost-benefit analysis to compare the actual efficacy of an internet-based behavioral treatment program against normal healthcare.
Technical Abstract: To determine whether a behavioral Internet treatment (BIT) program for weight management is a viable, cost-effective option compared with usual care (UC) in a diverse sample of overweight (average body mass index = 29 kg/m2), healthy adults (mean age = 34 years) serving in the US Air Force. Two-group parallel randomized controlled trial. Participants were randomly assigned into 2 groups: UC (n = 215) and UC plus BIT (n = 227). Baseline and 6-month assessments were included in the analyses. Primary outcome measures (changes in body weight, percent body fat, and waist circumference) and secondary outcome measures (Weight Efficacy Lifestyle [WEL] questionnaire) were included in an incremental cost-effectiveness analysis (ICEA) model. Costs were computed using the perspective of an agency wanting to replicate the intervention. Sensitivity analyses were performed to measure the robustness of models. Overall cost for BIT intervention was $11,178.40, or $49.24 per BIT participant. Total staff-time cost was $14.03 per BIT participant. Intervention cost was $25.92 per kilogram of weight loss and $28.96 per centimeter of waist-circumference loss. The cost was $37.88 for each additional point gained on the WEL subscale, where increasing scores indicate increased confidence in managing social pressures to eat. The BIT program is a cost-effective choice for weight management. It may cost more initially, but it results in long-term cost savings. Such cost-effective, Internet-based behavioral interventions for weight management could provide a valuable tool for preventive care aimed at improving individual and societal health.