Abstract
Background: Although there is a growing number of early childhood obesity prevention programs, only a few of them are effective in the long run. Even fewer reports exist on lifetime cost-effectiveness of early prevention strategies. This paper aimed to assess the lifetime cost-effectiveness of infant feeding modification aiming at reducing risk of later obesity. Methods: The simulation model consists of two parts: (a) Model I used data from the European Childhood Obesity Project (CHOP) trial (up to 6 years) and the German Interview and Examination Survey for Children (KiGGS) (6–17 years) to evaluate BMI trajectories of infants receiving either lower protein (LP) or higher protein (HP) content formula; and (b) Model II estimated lifetime cost-effectiveness based on Model I BMI trajectories. Compared to HP formula, LP formula feeding would incur lower costs that are attributable to childhood obesity across all decades of life. Results: Our analysis showed that LP formula would be cost-effective in terms of a positive net monetary benefit (discounted 3%) as an obesity prevention strategy. For the 19% of infants fed with formula in Germany, the LP strategy would result in cost savings of € 2.5 billion. Conclusions: Our study is one of the first efforts to provide much-needed cost-effectiveness evidence of infant feeding modification, thereby potentially motivating interventionists to reassess their resource allocation.
Highlights
Childhood obesity has become a major pediatric health concern as prevalence rates have increased substantially in the last few decades
For the 19% of infants fed with formula in Germany, the lower protein (LP) strategy would result in cost savings of € 2.5 billion
In conducting a cost-effectiveness analysis, we extended a modeling approach developed by Heidelberg University in 2017 that estimated the lifetime costs by taking the history of childhood overweight and obesity into account
Summary
Childhood obesity has become a major pediatric health concern as prevalence rates have increased substantially in the last few decades. Rates of childhood obesity in Europe, while lower than those in the US and Australia, have increased considerable in the last few decades [1]. This increasing prevalence of overweight and obesity in children is alarming for a number of reasons: immediate health effects, psychological and social consequences of weight stigma, increased costs to already strained primary health care sectors, the persistence of overweight and obesity into adulthood [2], and substantial long-term economic consequences [3,4]. (6–17 years) to evaluate BMI trajectories of infants receiving either lower protein (LP) or higher protein (HP) content formula; and (b) Model II estimated lifetime cost-effectiveness based on Model I. Conclusions: Our study is one of the first efforts to provide much-needed cost-effectiveness evidence of infant feeding modification, thereby potentially motivating interventionists to reassess their resource allocation
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