Cost effectiveness of family-based obesity treatment

Authors: QUATTRIN, TERESA - University Of Buffalo; Roemmich, James; PALUCH, ROCCO - University Of Buffalo; ECKER, MICHELLE - University Of Buffalo; EPSTEIN, LEONARD - University Of Buffalo

Submitted to: Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/27/2017
Publication Date: N/A
Citation: N/A

Interpretive Summary: The most effective way of treating childhood obesity is Family-Based therapy (FBT) that includes the parent most responsible for purchasing foods, cooking, and child care and the child in the same treatment. Both the obese children and their parents lose weight and become healthier. Such treatments are usually conducted at specialized centers such as Universities. In previous work we extended such a treatment for overweight/obese children and their parents out of a specialized Center and to the patient centered medical home, in effect the child’s pediatrician office. We found greater reductions in child and parent weight at 6 and 24 months compared to a usual pediatric obesity care group. For this paper we determined the cost-effectiveness of short and long-term weight change for FBT conducted in a pediatric-clinic based treatment compared to usual care. We studied 96 overweight/obese 2–5 year-old children and an overweight/obese parent randomly assigned to FBT in a pediatric clinic treatment or usual care, both receiving diet and activity education over 12 months followed by 12-month follow-up. We found that the cost per family to implement the treatment was $1,194 for FBT and $608 for usual care through 6 months and $1,629 for FBT and $886 for usual care throughout the 12 month study. Child percent over BMI change was 6.35 vs 2.15 at 6 months, and 1.98 versus a gain of 4.37 at 24 months for FBT and IC groups, respectively. Parent change was 6.19 versus 1.61 kg at 6 months and 5.95 versus 0.16 kg at 24 months for FBT and IC, respectively. When considering both the costs of the treatments and the amount of adiposity lost, the incremental cost effectiveness ratios were 117.01 children and 128.32 for parents. Thus, for families with overweight children and parents, FBT presents a more cost effective alternative than an information control group.

Technical Abstract: OBJECTIVE: Family-based behavioral treatment (FBT) is an evidence-based treatment for obese children and their parents. This treatment has been extended to treating overweight/obese children and their parents in the patient centered medical home. We reported greater reductions in child and parent weight at 6 and 24 months compared to an attention controlled information control group (IC). This paper reports the cost-effectiveness of short and long-term weight change for FBT compared to IC. RESEARCH METHODS AND PROCEDURES: Ninety-six overweight/obese 2–5 year-old children with parents who had BMI = 25 kg/m2 were randomly assigned to FBT or IC, both receiving diet and activity education over 12 months followed by 12-month follow-up. Weight loss and cost effectiveness were assessed both at 6 months and the 24 months. RESULTS: The average societal cost per family was $1,194 for FBT and $608 for IC through 6 months and $1,629 for FBT and $886 for IC throughout the whole study. Child percent over BMI change was 6.35 vs 2.15 at 6 months, and 1.98 versus a gain of 4.37 at 24 months for FBT and IC groups, respectively. Parent change was 6.19 versus 1.61 kg at 6 months and 5.95 versus 0.16 kg at 24 months for FBT and IC, respectively. The incremental cost effectiveness ratios were 117.01 children and 128.32 for parents. DISCUSSION: For families with overweight children and parents, FBT presents a more cost effective alternative than an information control group.