Economic Evaluation of an Internet-Based Weight Management Program

Objective: To determine whether a behavioral Internet treatment (BIT) program for weight management is a viable, cost-effective option compared with usual care (UC) in a diverse sample of overweight (average body mass index = 29 kg/m(2)), healthy adults (mean age = 34 years) serving in the US Air Force. Study Design: Two-group parallel randomized controlled trial. Methods: Participants were randomly assigned into 2 groups: UC (n = 215) and UC plus BIT (n = 227). Baseline and 6-month assessments were included in the analyses. Primary outcome measures (changes in body weight, percent body fat, and waist circumference) and secondary outcome measures (Weight Efficacy Lifestyle [WEL] questionnaire) were included in an incremental cost-effectiveness analysis (ICEA) model. Costs were computed using the perspective of an agency wanting to replicate the intervention. Sensitivity analyses were performed to measure the robustness of models. Results: Overall cost for BIT intervention was $11,178.40, or $49.24 per BIT participant. Total staff-time cost was $14.03 per BIT participant. Intervention cost was $25.92 per kilogram of weight loss and $28.96 per centimeter of waist-circumference loss. The cost was $37.88 for each additional point gained on the WEL subscale, where increasing scores indicate increased confidence in managing social pressures to eat. Conclusions: The BIT program is a cost-effective choice for weight management. It may cost more initially, but it results in long-term cost savings. Such cost-effective, Internet-based behavioral interventions for weight management could provide a valuable tool for preventive care aimed at improving individual and societal health. (Am J Manag Care. 2010; 16(4): e98-e104)