AI Article Synopsis
- - The study evaluated the cost-effectiveness of a mobile health-supported lifestyle intervention for pregnant individuals compared to standard care, focusing on various health outcomes like gestational weight gain (GWG) and quality-adjusted life years (QALYs).
- - Results indicated that the intervention group had a higher total cost (€3745) than the control group (€3471), but it still showed a higher probability of being cost-effective, particularly in reducing excessive GWG and large-for-gestational-age cases.
- - The analysis concluded that the mobile health intervention is likely cost-effective, especially if a specific maximum cost per outcome is considered, although further research is needed to grasp the long-term costs associated with outcomes like large-for-gestational
Article Abstract
Objective: To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.
Methods: We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost-effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG avoided, cost per case of excessive GWG averted, and cost per case of LGA averted.
Results: Total mean cost including intervention and health care utilisation was €3745 in the intervention group and €3471 in the control group (mean difference €274, P = 0.08). The ICER was €2914 per QALY gained. Assuming a ceiling ratio of €45,000, the probability that the intervention was cost-effective based on QALYs was 79%. Cost per kg of GWG avoided was €209. The cost-effectiveness acceptability curve (CEAC) for kg of GWG avoided reached a confidence level of 95% at €905, indicating that if one is willing to pay a maximum of an additional €905 per kg of GWG avoided, there is a 95% probability that the intervention is cost-effective. Costs per case of excessive GWG averted and case of LGA averted were €2117 and €5911, respectively. The CEAC for case of excessive GWG averted and for case of LGA averted reached a confidence level of 95% at €7090 and €25,737, respectively.
Conclusions: Results suggest that a mobile-health lifestyle intervention could be cost-effective; however, a better understanding of the short- and long-term costs of LGA and excessive GWG is necessary to confirm the results.
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| http://dx.doi.org/10.1038/s41366-020-0531-9 | DOI Listing |
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