Economic effects of interventions to reduce obesity in Israel

Table 3 Costs (NIS at 2010 price levels) and Effects of Dietary Interventions to Reduce Obesity.

Intervention (for fuller description See Appendix 1)	Study	Ref		Cost per Person	Cost per QALY	BMI decrease
25 ≤ BMI < 40					(f)
Clinical setting
Nutritional counseling
Various staff providing nutritional counseling over one year, modeled over lifetime	Ginsberg	[10]	(a, d)	57	50,543	0.05
General practitioner-based nutritional counseling over one year, modeled over lifetime	Olsen	[33]	(c)	395	4,379	0.22
Dietician-based nutritional counseling, over one year, modeled over lifetime	Olsen	[33]	(c)	860	31,982	0.07
Clinic-based, intensive lifestyle counseling for the obese over 3 years modeled over lifetime	J-van der Bruggen	[32]	(c, e)	798	26,769	0.90
Combined nutritional counseling and office support
Counseling by primary care internists trained in nutrition counseling with an office-support program tracked for one year Cost-utility estimates based on Israeli data	Ockene	[31]	(b, d)	74	< 0	0.81
*Community setting*
Community-based strategy using mass media campaigns, social support, risk factor screening and counseling in various settings over 5 years modeled over lifetime	J-van der Bruggen	[32]	(c, e)	35	19,938	0.15
BMI > 40
Clinical setting
Medical center staff counseling to adhere to a low carbohydrate diet over one year. Time horizon for cost utility analysis also one year	Tsai 2003	[34]	(c)	5,767	39,591	1.59
Medical center staff counseling to adhere to Standard NCEP 1 diet [g] over one year. Time horizon for cost utility analysis also one year	Tsai 2003	[34]	(c)	5,584	38,759	0.97

Notes: CS = Cost Saving
(a) Based on primary Israeli epidemiological, demographic and cost data.
Effectiveness from meta-analysis of international studies.
(b) Based on primary Israeli epidemiological and demographic data.
Cost data updated and converted to Israel 2010 price levels. Effectiveness from international study.
(c) Based on international data converted to Israel 2010 price levels.
(d) Based on cost per QALY at average 10 year AMI risk of 12.8% at age 55.
(e) Includes initial screening charge of 5.4 NIS per head [10].
(f) Ref [10] updated to 2010 price levels. All values are ACERs, average cost-effectiveness ratios.

ISSN: 2045-4015