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Within-Trial Cost-Effectiveness Analysis of a Family-Based Structured Lifestyle Modification Intervention Program for

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This study shows that a family-based lifestyle program effectively reduces cardiovascular risk factors and improves quality of life. The intervention is cost-effective, offering significant public health potential for broader adoption.

Keywords:
Cost-effectiveness analysisIschemic heart diseaseLifestyle interventionPreventive cardiology

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Area of Science:

  • Cardiovascular disease prevention
  • Health economics
  • Public health interventions

Background:

  • Premature coronary heart disease poses a significant health burden.
  • Family-based interventions can be effective in lifestyle modification.
  • Cost-effectiveness analysis is crucial for evaluating public health strategies.

Purpose of the Study:

  • To assess the cost-effectiveness of a targeted family-based structured lifestyle modification intervention for cardiovascular risk reduction.
  • To evaluate the impact of the intervention on risk factors and quality-adjusted life years (QALYs).

Main Methods:

  • The PROLIFIC study was an open-label, cluster randomized controlled trial.
  • Intervention included screening, structured lifestyle changes, and linkage to care, facilitated by non-physician health workers.
  • Costs were analyzed from a health system perspective over two years, measuring changes in risk factors and QALYs using EQ-5D-5 L.

Main Results:

  • The family-based intervention incurred an incremental cost of Int$ 157.5 per person with a gain of 0.014 QALYs over two years.
  • The within-trial incremental cost-effectiveness ratio (ICER) was 11,352 Int$/QALY.
  • Significant reductions were observed in systolic blood pressure, fasting plasma glucose, HbA1c, total cholesterol, and waist circumference.

Conclusions:

  • A family-based structured lifestyle modification program is cost-effective for cardiovascular risk reduction.
  • The intervention demonstrates a net gain in quality of life and holds potential for substantial public health impact.
  • The program is expected to be more cost-effective when implemented at scale over longer durations.