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. Author manuscript; available in PMC: 2012 Aug 27.
Published in final edited form as: Lancet. 2011 Aug 27;378(9793):838–847. doi: 10.1016/S0140-6736(11)60815-5

Table 1.

Cost-effectiveness results for selected interventions evaluated in Australia

Intervention Target population Strength of
evidence1
1=strongest
DALYs2
saved
Gross costs3
(AUD4
million)
Net cost per
DALY saved5
(AUD3 million)
Unhealthy food and beverage tax (10%)*84 Adults 4 170,000 1 Cost-saving6
Reduction of advertising of ‘junk food and beverages to children’# Children age 0– 14 2 37,000 0.13 Cost-saving
Front-of-pack traffic light nutrition labelling*84 Adults 5 32,000 4 Cost-saving
School-based education program to reduce TV viewing# Primary school children (8–10) 3 8,600 27.7 Cost-saving
Multi-faceted school-based program including nutrition and physical activity# Primary school children (age 6) 3 8,000 40 Cost-saving
School-based education program to reduce sugar sweetened drink consumption# Primary school children (7–11) 3 5,300 3.3 Cost-saving
Family based targeted program for obese children# Obese children (ages 10–11) 1 2,700 11 Cost-saving
Multi-faceted targeted school-based program# Overweight/obese primary school children (ages 7–10) 3 270 0.56 Cost-saving
Gastric banding - adolescents#113 Severely obese adolescents (ages 14–19) 1 12,300 130 4,400
Family-based GP-mediated program#114 Overweight/ moderately obese children (ages 5–9) 3 510 6.3 4,700
Gastric banding – adults* Adults BMI>35 1 140,000 120 5,800
Multi-faceted school-based program without an active physical activity component# Primary school children (age 6) 3 1,600 51.2 21,300
Diet and exercise* Adults BMI >25 1 3,000 140 28,000
Low fat diet* Adults BMI>25 1 1,900 94 37,000
Active After Schools Communities Program#115 Primary school children (5–11) 5 450 40.3 82,000
Weight Watchers* Adults 1 54 5 84,000
Lighten Up to a Healthy Lifestyle weight loss program* Adults 4 38 4 94,000
TravelSMART Schools# Primary school children (ages 10–11) 4 90 13.1 117,000
Orlistat* Adults BMI>30 1 2,100 1,500 700,000
Walking School Bus# Primary school children (ages 5–7) 3 450 40.3 760,000
*

Interventions drawn from ACE-Prevention study 2010.74

#

Interventions drawn from Ace-Obesity study.73

1

This classification (1 = strongest; 5 = weakest) is based on criteria adopted in ACE-Prevention.74 1) ‘Sufficient evidence of effectiveness’ Effectiveness is demonstrated by sufficient evidence from well-designed research that the effect: is unlikely to be due to chance (e.g. p<0.05); and is unlikely to be due to bias, e.g. evidence from: a level I study design; several good quality level II studies; or several high quality level III-1 or III-2 studies from which effects of bias and confounding can be reasonably excluded on the basis of the design and analysis. 2) ‘Likely to be effective’ Effectiveness results are based on: sound theoretical rationale and program logic; and level IV studies, indirect or parallel evidence for outcomes; or epidemiological modeling to the desired outcome using a mix of evidence types or levels. The effect is unlikely to be due to chance. Implementation of this intervention should be accompanied by an appropriate evaluation budget. 3) ‘Limited evidence of effectiveness’ is demonstrated by limited evidence from studies of varying quality (can be level II or II studies) 4) ‘May be effective’ is similar to 2) but with potential lack of significance and confounding. 5) inconclusive or inadequate evidence (5 or 6 in original studies).

2

DALYs = Disability-adjusted life years saved which combine premature death (years of life lost) and morbidity (years lived with a disability)

3

Gross costs = intervention costs

4

AUD = Australian dollars (1 AUD=0.998 US)

5

Net cost per DALY saved = Gross costs minus cost offsets divided by number of DALYs saved

6

Cost-saving = achieves both health gain and cost savings (“dominant”)