Cost-effectiveness of obesity prevention in early childhood: A systematic literature review of methods and applications: Finn Rasmussen

Background

Despite methodological advances in economic modelling, cost-effectiveness studies in primary prevention intervention targeting children are currently insufficiently applied. The aim of the present study was to explore existing methods and applications of cost-effectiveness studies within early childhood obesity prevention.

Methods

A systematic literature review was conducted using the main electronic databases for health sciences and health economic evaluations, including PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Peer-reviewed full economic evaluations published in English or German between January 2004 and November 2015 were considered for review. Eligible were studies including either a trial-based cost-effectiveness analysis or a simulation-based cost-effectiveness analysis of an obesity prevention targeting preschool children and/or their parents.

Results

Of the 728 studies identified in the initial search, 717 were excluded after scrutiny of the abstracts. The remaining 11 articles were retained for subsequent detailed assessment; among those, six were in line with our eligibility criteria and were included for analysis. They included five intervention studies, of which four were (cluster-) randomised trials and one a quasi-experimental intervention study. The sixth study was based on a simulation study conducted on secondary data. The descriptive quality assessment of the included economic evaluations presented varying degrees of integrity and completion.

Conclusions

While the need for cost-effectiveness studies on obesity prevention programmes in early childhood is immense, only a few studies of varying quality have been conducted. Moreover, due to methodological weaknesses, they have provided only limited information for policy makers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.