PRIMEtime CE: a multistate life table model for estimating the cost-effectiveness of interventions affecting diet and physical activity

ObjectiveTo estimate health-adjusted life years (HALY) gained in the Solomon Islands for the 2016 population over the remainder of their lives, for three interventions: hypothetical eradication of cigarettes; 25% annual tax increases to 2025 such that tax represents 70% of sales price of tobacco; and a tobacco-free generation (TFG).DesignWe adapted an existing multistate life table model, using Global Burden of Disease (GBD) and other data inputs, including diseases contributing >5% of the GBD estimated disability-adjusted life years lost in the Solomon Islands in 2016. Tax effects used price increases and price elasticities to change cigarette smoking prevalence. The TFG was modelled by no uptake of smoking among those 20 years and under after 2016.ResultsUnder business as usual (BAU) smoking prevalence decreased over time, and decreased faster under the tax intervention (especially for younger ages). For example, for 20-year-old males the best estimated prevalence in 2036 was 22.9% under BAU, reducing to 14.2% under increased tax. Eradicating tobacco in 2016 would achieve 1510 undiscounted HALYs per 1000 people alive in 2016, over the remainder of their lives. The tax intervention would achieve 370 HALYs per 1000 (24.5% of potential health gain), and the TFG 798 HALYs per 1000 people (52.5%). By time horizon, 10.5% of the HALY gains from tax and 8.0% from TFG occur from 2016 to 2036, and the remainder at least 20 years into the future.ConclusionThis study quantified the potential of two tobacco control policies over maximum health gains achievable through tobacco eradication in the Solomon Islands.

Download Full-text

Cost effectiveness of the NHS breast screening programme: life table model

BMJ ◽

10.1136/bmj.f3822 ◽

2013 ◽

Vol 346 (jun12 1) ◽

pp. f3822-f3822

Keyword(s):

Cost Effectiveness ◽

Life Table ◽

Breast Screening ◽

Screening Programme ◽

Breast Screening Programme ◽

Table Model ◽

Life Table Model

Download Full-text

It Takes a Village Coach: Cost-Effectiveness of an Intervention to Improve Diet and Physical Activity Among Minority Women

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0285 ◽

2018 ◽

Vol 15 (11) ◽

pp. 819-826

Author(s):

Iris Buder ◽

Cathleen Zick ◽

Norman Waitzman ◽

Sara Simonsen ◽

Grant Sunada ◽

...

Keyword(s):

Physical Activity ◽

Cost Effectiveness ◽

Health Workers ◽

Cost Effective ◽

Health Coaching ◽

Dietary Guidelines ◽

Coaching Intervention ◽

Life Years ◽

Diet And Physical Activity ◽

The Cost

Background: This study gauged the cost-effectiveness of a community-based health coaching intervention aimed at improving diet and physical activity among women in culturally diverse communities. Methods: The Coalition for a Healthier Community for Utah Women and Girls recruited women from 5 cultural and ethnic groups and randomized them to receive quarterly versus monthly health coaching. Coaching was performed by trained community health workers from the targeted communities. Cost-effectiveness ratios were estimated to gauge the cost-effectiveness of the intervention. Results: Estimated quality-adjusted life years gained from both increased physical activity and improved diet were positive. Cost-effectiveness ratios varied by intervention arm, but all ratios fell within the favorable range described in the literature. Conclusions: This culturally adapted health coaching intervention was deemed to be cost-effective. Our findings suggest that to achieve the highest level of cost-effectiveness, programs should focus on enrolling at-risk women who do not meet recommended physical activity standards and/or dietary guidelines.

Download Full-text

A MULTISTATE LIFE TABLE MODEL INCLUDING DISEASE RECOVERY FOR ASSESSING THE HEALTH IMPACTS OF CHRONIC ENVIRONMENTAL EXPOSURES

ISEE Conference Abstracts ◽

10.1289/isee.2011.01510 ◽

2011 ◽

Vol 2011 (1) ◽

Author(s):

James Milner ◽

Zaid Chalabi ◽

Paul Wilkinson ◽

Sotiris Vardoulakis ◽

Michael Davies

Keyword(s):

Life Table ◽

Environmental Exposures ◽

Health Impacts ◽

Table Model ◽

Life Table Model ◽

Disease Recovery ◽

Multistate Life Table

Download Full-text

Diet and physical activity in pregnancy to prevent gestational diabetes: a protocol for an individual participant data (IPD) meta-analysis on the differential effects of interventions with economic evaluation

BMJ Open ◽

10.1136/bmjopen-2020-048119 ◽

2021 ◽

Vol 11 (6) ◽

pp. e048119

Author(s):

Dyuti Coomar ◽

Jonathan M Hazlehurst ◽

Frances Austin ◽

Charlie Foster ◽

Graham A Hitman ◽

...

Keyword(s):

Physical Activity ◽

Cost Effectiveness ◽

Gestational Diabetes ◽

Systematic Reviews ◽

Meta Analysis ◽

Individual Participant Data ◽

Randomised Trials ◽

Diet And Physical Activity ◽

Individual Participant ◽

In Pregnancy

IntroductionMothers with gestational diabetes mellitus (GDM) are at increased risk of pregnancy-related complications and developing type 2 diabetes after delivery. Diet and physical activity-based interventions may prevent GDM, but variations in populations, interventions and outcomes in primary trials have limited the translation of available evidence into practice. We plan to undertake an individual participant data (IPD) meta-analysis of randomised trials to assess the differential effects and cost-effectiveness of diet and physical activity-based interventions in preventing GDM and its complications.MethodsThe International Weight Management in Pregnancy Collaborative Network database is a living repository of IPD from randomised trials on diet and physical activity in pregnancy identified through a systematic literature search. We shall update our existing search on MEDLINE, Embase, BIOSIS, LILACS, Pascal, Science Citation Index, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Technology Assessment Database without language restriction to identify relevant trials until March 2021. Primary researchers will be invited to join the Network and share their IPD. Trials including women with GDM at baseline will be excluded. We shall perform a one and two stage random-effect meta-analysis for each intervention type (all interventions, diet-based, physical activity-based and mixed approach) to obtain summary intervention effects on GDM with 95% CIs and summary treatment–covariate interactions. Heterogeneity will be summarised using I2 and tau2 statistics with 95% prediction intervals. Publication and availability bias will be assessed by examining small study effects. Study quality of included trials will be assessed by the Cochrane Risk of Bias tool, and the Grading of Recommendations, Assessment, Development and Evaluations approach will be used to grade the evidence in the results. A model-based economic analysis will be carried out to assess the cost-effectiveness of interventions to prevent GDM and its complications compared with usual care.Ethics and disseminationEthics approval is not required. The study is registered on the International Prospective Register of Systematic Reviews (CRD42020212884). Results will be submitted for publication in peer-reviewed journals.

Download Full-text