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Health Promotion International Advance Access originally published online on October 4, 2007
Health Promotion International 2007 22(4):271-283; doi:10.1093/heapro/dam027
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© The Author (2007). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Time to give nutrition interventions a higher profile: cost-effectiveness of 10 nutrition interventions

Kim Dalziel* and Leonie Segal

Health Economics, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia

* Corresponding author. E-mail: kim.dalziel{at}unisa.edu.au


  Abstract

The aim of this study was to evaluate the economic performance of 10 nutrition interventions. The interventions included Mediterranean Diet, Intensive Lifestyle Change (nutrition and physical activity) to Prevent Diabetes, Reduced Fat Diet for persons with IGT, Nutritional Counselling in GP (GP, general practice/primary care), Nurse Counselling in GP, Oxcheck Nurse Health Checks in GP, Gutbusters Workplace (for men), Talking Computer, Multi Media 2 fruit 5 veg Campaign and the FFFF (Fighting Fit, Fighting Fat) Media Campaign. Markov models were constructed in order to estimate economic performance expressed as cost per QALY (quality adjusted life year) gained. Data from original clinical trial reports were used to populate the models, supplemented by the wider literature where required. Performance of the Mediterranean Diet and Intensive Lifestyle Change to Prevent Diabetes interventions could be estimated with most certainty and both were highly cost-effective interventions, at AU $1020 (US $760, £410) and AU $1880 (US $1410, £750) per QALY gained, respectively. The media campaign interventions appear highly cost-effective at AU $46 (US $34, £18) for ‘2 fruit 5 veg’ and AU $5600 (US $4200, £2200) per QALY gained for FFFF, but are associated with considerable uncertainty, and may be dominated under certain assumptions. Several interventions were cost-saving under plausible sets of assumptions, whereas a small number were potentially dominated. All interventions subject to economic evaluation appeared cost-effective relative to societal norms. Nutrition interventions can constitute a highly efficient component of a strategy to reduce the growing disease burden linked to over/poor nutrition. There is an urgent need for high-quality trial data from which economic performance of nutrition interventions can be modelled.

Key words: nutrition; risk factors; economic analysis; cost-effectiveness


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