Cost-Effectiveness of 5 Public Health Approaches to Prevent Eating Disorders

Authors

Michael W. Long, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia. Electronic address: michael_long@gwu.edu.
Zachary J. Ward, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Davene R. Wright, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts.
Patricia Rodriguez, Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, Washington.
Nathan W. Tefft, Amazon.com, Seattle, Washington.
S Bryn Austin, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.

Document Type

Journal Article

Publication Date

9-12-2022

Journal

American journal of preventive medicine

DOI

10.1016/j.amepre.2022.07.005

Abstract

INTRODUCTION: Eating disorders cause suffering and a high risk of death. Accelerating the translation of research into implementation will require intervention cost-effectiveness estimates. The objective of this study was to estimate the cost-effectiveness of 5 public health approaches to preventing eating disorders among adolescents and young adults. METHODS: Using data from 2001 to 2017, the authors developed a microsimulation model of a closed cohort starting at the age of 10 years and ending at 40 years. In 2021, an analysis was conducted of 5 primary and secondary prevention strategies for eating disorders: school-based screening, primary care‒based screening, school-based universal prevention, excise tax on over-the-counter diet pills, and restriction on youth purchase of over-the-counter diet pills. The authors estimated the reduction in years lived with eating disorders and the increase in quality-adjusted life-years. Intervention costs and net monetary benefit were estimated using a threshold of $100,000/quality-adjusted life year. RESULTS: All the 5 interventions were estimated to be cost-saving compared with the current practice. Discounted per person cost savings (over the 30-year analytic time horizon) ranged from $63 (clinic screening) to $1,102 (school-based universal prevention). Excluding caregiver costs for binge eating disorder and otherwise specified feeding and eating disorders substantially reduced cost savings (e.g., from $1,102 to $149 for the school-based intervention). CONCLUSIONS: A range of public health strategies to reduce the societal burden of eating disorders are likely cost saving. Universal prevention interventions that promote healthy nutrition, physical activity, and media use behaviors without introducing weight stigma may prevent additional negative health outcomes, such as excess weight gain.

APA Citation

Long, Michael W.; Ward, Zachary J.; Wright, Davene R.; Rodriguez, Patricia; Tefft, Nathan W.; and Austin, S Bryn, "Cost-Effectiveness of 5 Public Health Approaches to Prevent Eating Disorders" (2022). GW Authored Works. Paper 1635.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1635

Department

Prevention and Community Health