Cost-effectiveness of a distance lifestyle counselling programme
among overweight employees from a company perspective, ALIFE@Work: A randomized
controlled trial
Affiliations: Department of Health Sciences and EMGO Institute for
Health and Care Research, Faculty of Earth and Life Sciences, VU University,
Amsterdam, The Netherlands | Department of Epidemiology and Biostatistics and EMGO
Institute for Health and Care Research, VU University Medical Center,
Amsterdam, The Netherlands | Body@Work, Research Center Physical Activity, Work and
Health, TNO-VU University Medical Center, Amsterdam, The Netherlands | Department of Epidemiology, Municipal Health Service,
The Hague, The Netherlands | Department of Public and Occupational Health and EMGO
Institute for Health and Care Research, VU University Medical Center,
Amsterdam, The Netherlands
Note: [] Address for correspondence: M.F. van Wier, Department of Health
Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De
Boelelaan 1085, 1081 HV Amsterdam, The Netherlands. Tel.: +31 205 983 638;
E-mail: mvanwier@gmail.com
Abstract: OBJECTIVE: The objective of this study was to determine whether a
lifestyle intervention with individual counselling was cost-effective for
reducing body weight compared with usual care from a company perspective. PARTICIPANTS: Overweight employees were recruited and randomly
assigned to the intervention groups, either phone or Internet, or the control
group. METHODS: The intervention was based on a cognitive behavioural
approach and addressed physical activity and diet. Self-reported body weight
was collected at baseline and 12 months follow-up. Intervention costs and costs
of sick leave days based on gross and net lost productivity days (GLPDs/NLPDs)
obtained from the participating companies were calculated. Missing data were
imputed using multiple imputation techniques. Uncertainty surrounding the
differences in costs and the incremental cost-effectiveness ratios (ICER) was
estimated by bootstrapping techniques, and presented on cost-effectiveness
planes and cost-effectiveness acceptability curves. RESULTS: No statistically significant differences in total costs
were found between the intervention groups and control group, though mean total
costs in both intervention groups tended to be higher than those in the control
group. The ICER of the Internet group compared with the control group was
�59 per kilogram of weight loss based on GLPD costs. The probability of
cost effectiveness of the Internet intervention was 45% at a willingness-to-pay
of �0 per extra kilogram weight loss and 75% at a willingness-to-pay of
�1500 per extra kilogram body weight loss. Comparable results were found
for the phone intervention. CONCLUSIONS: The intervention was not cost effective in comparison
with usual care from the company perspective. Due to the large amount of
missing data, it is not possible to draw firm conclusions.
Keywords: Body weight, economic evaluation, employer, occupational health care, sick leave
