Cost-Effectiveness of a Clinical Childhood Obesity Intervention

Area of Science:

• Public Health
• Pediatric Medicine
• Health Economics

Background:

• Childhood obesity is a significant public health concern with long-term health and economic consequences.
• Existing clinical interventions for childhood obesity have shown variable effectiveness and cost-efficiency.
• The Study of Technology to Accelerate Research (STAR) intervention integrates electronic health record (EHR) decision support for clinicians with parent-focused behavior change support.

Purpose of the Study:

• To evaluate the cost-effectiveness of a national implementation of the STAR intervention for childhood obesity.
• To estimate the potential population impact of the STAR intervention on obesity prevalence.
• To assess the economic viability of using EHR-based decision support in pediatric practices.

Main Methods:

• A microsimulation model was developed to simulate the national implementation of the STAR intervention from 2015 to 2025.
• The model included pediatric primary care providers with functional EHRs across the United States.
• Key outcomes measured included intervention costs, changes in BMI, obesity prevalence, and cost-effectiveness metrics.

Main Results:

• A 10-year national implementation is projected to reach approximately 2 million children.
• The intervention is estimated to cost $119 per child and $237 per BMI unit reduced.
• It is expected to avert 43,000 obesity cases and 226,000 life-years with obesity, at a net cost of $4085 per case and $774 per life-year.

Conclusions:

• The STAR intervention demonstrates potential for greater cost-effectiveness compared to prior clinical childhood obesity interventions.
• Integrating clinician decision support with parent-guided behavior change is a viable strategy.
• This approach could complement population-level strategies to accelerate reductions in childhood obesity prevalence.