Assessing cost-effectiveness of obesity prevention policies in Australia

ACE-obesity policy 2018
Obesity Public health Australia

The current obesity epidemic in Australia and around the globe has significant negative health and economic consequences. Addressing this problem will require a comprehensive societal response, including implementation of a suite of multi-sectoral government policies. Informed government action requires reliable comparative evidence on the costs and benefits of various policy options.

ACE-Obesity Policy is a priority-setting study that aimed to evaluate the economic credentials of a range of obesity prevention policies (including both regulatory and program-based interventions), across multiple sectors and multiple areas of governance (local, state and federal governments, and the private sector). The study formed part of the broader body of work of the National Health and Medical Research Council funded Centre of Research Excellence in Obesity Policy and Food Systems (APP1041020: 2012-2018), and answered the research question: “What are the most effective, cost- effective, affordable and implementable policy options to prevent obesity across a range of settings?”

The Assessing Cost-Effectiveness (ACE) approach was adopted – characterised by the use of consistent, rigorous methods for the technical cost-effectiveness analyses (including extensive uncertainty analyses), alongside qualitative analyses of key implementation considerations relevant to policy decisions (strength of evidence, equity, acceptability, feasibility, and sustainability). The modelling of expected health benefits and related costs in response to an intervention was based on a previously developed proportional, multi-state, life table Markov model.

Key advancements made to the model as part of the ACE-Obesity Policy study included:

  • the integration of physical activity and fruit and vegetables intake as risk factors (in addition to body mass index);
  • the development of an equity-focused version of the model that allowed the quantification of the differential cost, health and cost-effectiveness outcomes across different socio-economic position (SEP) groups; and modifications to allow better quantification of interventions targeted at children.

Intervention selection was based on a deliberative process that included consideration of:

  1. the potential impact on addressing obesity in Australia;
  2. the relevance to current policy decision-making; and
  3. the availability of evidence for intervention effectiveness.

Full economic evaluations were conducted for 16 interventions, with 50 different scenarios explored. Evidence reviews were completed for a further 12 interventions, but full economic modelling was not conducted due to the lack of evidence for effectiveness required to complete a robust evaluation.

ACE-Obesity Policy is a priority- setting study that aimed to evaluate the economic credentials of a range of obesity prevention policies across multiple sectors and multiple areas of governance.

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