Cost-Effectiveness Analysis of a Community-Based Telewellness Weight Loss Program

Area of Science:

• Public Health
• Health Economics
• Behavioral Medicine

Background:

• Obesity and overweight affect millions of women, particularly those with low incomes, necessitating accessible and effective interventions.
• Community-based telewellness programs offer a scalable approach to weight management.
• Previous research demonstrated the Koa Family Program's efficacy in achieving significant weight loss.

Purpose of the Study:

• To conduct a cost-effectiveness analysis of the Koa Family Program, a telewellness intervention for overweight/obese, low-income women aged 21-45.
• To compare the incremental costs with the incremental effectiveness (weight loss) of the program.
• To assess the program's value for money from a funder's perspective.

Main Methods:

• A prospective 25-week randomized controlled trial (RCT) involving 70 women (BMI 25-40 kg/m²) was used.
• Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and incremental net benefit (INB).
• Statistical uncertainty was assessed using willingness-to-pay plots and cost-effectiveness acceptability curves.

Main Results:

• The average cost per participant ranged from $407.34 to $726.22, with a base case of $564.39.
• Participants achieved an average weight loss of 7.7 pounds over 25 weeks.
• The base case ICER was approximately $73 per pound lost, with a 90-95% probability of cost-effectiveness at willingness-to-pay thresholds of $115-$140 per pound.

Conclusions:

• The Koa Family Program demonstrates good value and cost-effectiveness, comparable to other weight-loss interventions.
• The program's effectiveness is notable given its focus on a vulnerable, low-income population.
• Telewellness interventions can be a viable and economical strategy for addressing obesity in underserved communities.