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Estimated Costs and Cost-Effectiveness of a Pediatric Weight Management Program
Meg Simione1,2, Sophie Wagner3, Caroline J Kistin4
1Department of Pediatrics, Mass General for Children, Boston, Massachusetts.
Insights
The Connect for Health program is a cost-effective pediatric weight management intervention, demonstrating value for healthcare systems serving at-risk children. This study provides crucial economic data for obesity intervention adoption.
Area of Science:
- Public Health
- Health Economics
- Pediatric Medicine
Background:
- Childhood obesity presents significant public health challenges with persistent disparities.
- Economic evaluations are vital for resource allocation in pediatric obesity interventions.
Purpose of the Study:
- To develop and analyze a simulation model for the Connect for Health program.
- To estimate implementation costs and assess the cost-effectiveness of this pediatric weight management program.
Main Methods:
- A Markov cohort model was utilized, based on a randomized clinical trial and an implementation study.
- Costs of implementation and incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) were calculated.
- The model simulated program implementation in a cohort mirroring the RCT population.
Main Results:
- Implementation costs were estimated at $58,000 (startup) and $1,300 (monthly).
- The Connect for Health strategy showed an ICER of $10,554 per QALY gained over 2 years.
- A threshold of 534 children was identified for effective cost amortization.
Conclusions:
- The Connect for Health program was found to be cost-effective in this economic evaluation.
- Findings support healthcare systems in decisions regarding the adoption of pediatric obesity interventions.
- This research is crucial for improving access to obesity-related care for underserved children.
Importance:
Childhood obesity remains a significant public health challenge, with ongoing racial, ethnic, and socioeconomic disparities in its prevention and treatment. Economic evaluations of pediatric obesity interventions are essential for guiding resource allocation in health care settings.
Objective:
To develop and analyze a simulation model of the Connect for Health program to estimate the costs of implementing the program and assess its cost-effectiveness.
Design, Setting, And Participants:
This economic evaluation used a Markov cohort model based on the Connect for Health randomized clinical trial (RCT) conducted from June 2014 through March 2016 and the Connect for Health implementation study conducted at 2 academic medical centers in Boston, MA. The study first estimated costs of implementation for new sites, and then simulated program implementation in a cohort that mirrored the RCT population. Data were analyzed from October 2023 to March 2025.
Exposure:
The Connect for Health pediatric weight management program.
Main Outcomes And Measures:
Outcomes include costs associated with program implementation and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained.
Results:
This study used a cohort of 2494 individuals to mirror the RCT population and included 1178 female participants (47%), a mean (SD) age of 8.0 (3.0) years, and a mean (SD) body mass index z score of 1.91 (0.56). The costs of implementing the Connect for Health program in primary care settings were estimated at $58 000 in 1-time startup costs and $1300 in ongoing monthly costs. The economic model showed that the Connect for Health strategy had an ICER of $10 554 per QALY gained over 2 years compared with no intervention. The study found a threshold of 534 children in a cohort was needed to effectively amortize costs.
Conclusions And Relevance:
In this economic evaluation of a pediatric weight management program, the Connect for Health program was estimated to be cost-effective. These findings are important for health care systems that serve children who are less likely to receive obesity-related care in making decisions about program adoption.
