Abstract
BackgroundThe aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study.MethodsThe Assessing Cost Effectiveness (ACE) approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'.ResultsThe intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum) and when expressed as a 'cost per child' estimate (from <AUD1.0 [reduction of TV advertising of high fat foods/high sugar drinks] to AUD31,553 [laparoscopic adjustable gastric banding for morbidly obese adolescents]). High costs per child reflected cost structure, target population and/or under-utilisation.ConclusionThe use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and second stage filter considerations for each intervention assessed will be presented and analysed.
Highlights
The aim of the Assessing Cost Effectiveness (ACE)-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents
Scarcity of funds dedicated to public health means that difficult choices of what to fund to reverse the trend in unhealthy weight gain are inevitable
Choice of comparator One of the fundamental questions for economic evaluation is 'what difference the option for change makes to current policy?' the comparator to the interventions selected as options for change in the ACE studies was 'current practice'
Summary
The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. Obesity is universally acknowledged as a major public health problem, both in children and adults [1,2]. This raises vital public health questions concerning what interventions are necessary to control the obesity epidemic; whether our early endeavours to confront obesity are the right choices; and whether they are sufficient to reverse the obesity trends. While there is nothing new about the task of making difficult choices in health care, policy-makers are discussing with renewed interest the issue of how to set priorities which are evidence-based. Cost-effectiveness analyses can provide additional evidence-based information to help decision-makers set priorities and answer difficult questions such as those posed above.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
