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The Cost-Effectiveness of Educational Interventions. Michele Cecchini Health Division. The obesity epidemic. Obesity has become a top public health priority and it is set to increase further Environmental influences on lifestyles played a major role, fuelled by a “social multiplier” effect
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The Cost-Effectiveness of Educational Interventions Michele Cecchini Health Division
The obesity epidemic • Obesity has become a top public health priority and it is set to increase further • Environmental influences on lifestyles played a major role, fuelled by a “social multiplier” effect • OECD Governments very active in last 5-10 years implementing programmes to improve diets and physical activity • Limited evidence on the effective of interventions and virtually no evidence of their efficiency and distributional impact
Modelling Approach • Generalized cost-effectiveness analysis • Acknowledges global budget constraints • Allows the comparison of interventions within and outside the health sector • Identifies the mix of interventions that generates the largest health gain • Microsimulation model • “Causal web” of risk factors influences the development of diseases • European population (gender, age, SES) • 100 year perspective • Potential policies assessed keeping constant all other parameters
Cancers Stroke Ischemic heart disease
Impact of prevention on obesity mass media campaigns school-based interventions worksite interventions
Prevention does save lives… mass media campaigns 1 LY/DALY every 115/121 indiv. school-based interventions worksite interventions 1 LY/DALY every 12/10 indiv.
Health outcomes & costs by age groupSchool-based intervention Impact on health expenditure (selected diseases) Health outcomes
Spending on prevention is a goodlong-term investment Food advert reg School-based int worksite interventions school-based interventions mass media camp
Conclusions • Prevention, educational interventions included, is a good way of spending money to improve health • Interventions, especially those aimed at children, may take a long time to make an impact and reach favourable cost-effectiveness ratios • Impact on health expenditure is limited relative to intervention costs • Some private sector interventions are cost-effective and may shift costs away from government budgets www.oecd.org/health/prevention