Table 2.
Study description and key economc findings (alphabetically sorted)
| Author/Year/(Country) | Intervention components | Target/Age group | Setting | Study design | Perspective, time horizon, discounting | Measure of effects | Price Year/Currency unit, considered cost categories | Result [in 2011 US$]* |
|---|---|---|---|---|---|---|---|---|
| Brown et al. 2007 (USA) [23] | Physical activity, nutrition | Children, grades three, four and five, 8–11 years | School | CUA, using a model approach (calculating additional benefit) | Society, modeling over a 25-year period, costs and benefits at 3 % | Cases of adult overweight prevented (40–64 years), QALYs saved | 2004, US$, intervention costs, avoided treatment costs, avoided productivity loss costs | Cost per QALY saved = US$ 900 [US$ 1072.52], Net benefit = US$ 68,125 [US$ 81,183.60] |
| Kesztyüs et al. 2011 (GER) [26] | Health education, physical activity breaks, and parent involvement | Children, primary school, second grade, 7–8 years | School | CEA, using intervention results | Society, 1 year, not stated | Differences in waist-to-height ratio, waist circumference, and BMI, | 2008, EUR, total intervention costs, intervention costs per child | ICER (WC) = EUR 11.11 [US$ 14.67] per cm prevented |
| ICER (WHtR) = EUR 18.55 [US$ 24.50] per unit prevented | ||||||||
| Krauth et al. 2013 (GER) [28] | 3 additional PE lessons per week | Children, primary school | School | CEA, using intervention results | Society, not stated, not stated | Reduction in BMI, increase in physical activity | No price year, EUR, intervention costs, intervention costs per child per school year | EUR 619/child/year for significant results [US$ 789.54] |
| McAuley et al. 2010 (NZ) [29] | Nutrition and physical activity | Children, 5–12 years | School/Community | CEA, using intervention results | Society, 4 years, costs at 5 % | Weight gain avoided, QALY | 2006, NZ$, no development costs, total costs | NZ$ 664–1708 [US$ 515.53–1326.1] per kg avoided weight gain (depending on age), no QALY gain reported |
| Moodie et al. 2009 (AUS) [22] | “Walking School Bus” encouraging physical activity | Children, 5–7 years | School/Community | CUA, using a model approach | Society, lifetime, costs and benefits both at 3 % | Reduction in BMI, increase in physical activity, energy expenditure | 2001, AU$, total costs | Lifetime DALYs, Cost per: DALY saved: AU$ 760,000 [US$ 669,138.39] (net, gross: AU$ 770,000 [US$ 677,942.84]) |
| - BMI unit saved: AU$ 87,000 [US$ 76,598.74] | ||||||||
| Moodie et al. 2010 (AUS) [34] | After-school care for children from 3 to 5 pm including a physical activity program | Children, primary school, 5–11 years | School | CUA, using a model approach | Society, lifetime, costs and benefits both at 3 % | Reduction in BMI, increase in physical activity, energy expenditure | 2001, AU$, total cost | Lifetime DALYs, Gross cost per: |
| - DALY saved: AU$ 82,000 [US$ 72,196.51] (net, gross: AU$ 90,000 [US$ 79,240.07] | ||||||||
| - BMI unit saved: AU$ 8200 [US$ 7219.65] | ||||||||
| Moodie et al. 2011 (AUS) [35] | Lessons, information evenings, promotion of the program | Children, 5th and 6th school years, 10–11 years | School/Community | CUA, using a model approach | Society, lifetime, costs and benefits both at 3 % | Reduction in BMI, increase in physical activity, energy expenditure, DALY | 2001, AU$, total costs | Lifetime DALYs, Cost per: |
| - DALY saved: AU$ 117,000 [US$ 103,012.09] (net, gross: AU$ 125,000 [US$ 110,055.66]) | ||||||||
| - BMI unit saved: AU$ 13,000 [US$ 11,445.79] | ||||||||
| Moodie et al. 2013 (AUS) [30] | Interdisciplinary approach, including nutrition and physical activity and reducing screen time | Children, 4–12 years | School/Community | CUA, using a model approach | Society, lifetime, costs and benefits both at 3 % | Reduction in BMI, DALY | 2006, AU$, total costs | Lifetime DALYs, Cost per: |
| - DALY saved: AU$ 20,227 [US$ 15,478.09] (net, gross: AU$ 22,978 [US$ 17,583.21]) | ||||||||
| - BMI unit saved: AU$ 399 [US$ 305.32] | ||||||||
| Peterson et al. 2008 (USA) [21] | Media campaign | Teenagers, 12–17 years | Society | CEA, using intervention results | Only program costs, not reported, not stated | Questionnaire, extrapolated to population: “contemplated doing more exercise”, “has done more exercise” | No price year, US$, development costs of the program and costs for “product placement” | Cost per person who did more exercise: between US$ 5.11 [US$ 6.68] and US$ 153.19 [US$ 200.12] for the individual sections of the campaign, US$ 8.87 [US$ 11.59] for the whole campaign |
| Pringle et al. 2010 (UK) [24] | Activity classes, free swimming activities | Population (children 10–17 years) | Community | CUA, using a model approach | Key implementation and running costs, not stated, not stated | Change in MPA, QALY | 2003, £, costs/completer improving MPA | Cost per QALY gained |
| - Activity: £ 94 [US$ 166.07] | ||||||||
| - Swimming: £ 103 [US$ 181.97] | ||||||||
| NHS savings per completer | ||||||||
| - Activity: £ 769 [US$ 1358.59] | ||||||||
| - Swimming: £ 2111 [US$ 3729.49] | ||||||||
| Rush et al. 2014 (NZ) [37] | Multicomponent through-school physical activity and nutrition program | Primary school children, 6–8 and 9–11 years | School | CUA, using a model approach | Funder’s perspective, lifetime, costs and outcomes both at 3.5 % | QALY, increased life expectancy. | 2011, NZ$, lifetime costs, incremental costs | ICER/QALY (older children): NZ$ 24,690 [US$ 16,570.47], ICER/QALY (younger children): NZ$ 30,438 [US$ 20,428.19] |
| Existing model used to extrapolate the effects and costs | ||||||||
| Wang et al. 2003 (USA) [36] | Interdisciplinary approach, lessons, sport materials, wellness, teacher training | Children 6th–8th school year, 11–13 years | School | CUA, using a model approach (calculating additional benefit) | Society, modeling over a 25-year period, costs and benefits both at 3 % | Cases of adult overweight prevented (5.805), QALYs (4.13) | 1996, US$, intervention costs, avoided treatment costs, avoided productivity loss costs | Cost per QALY saved: US$ 4305 [US$ 6179.08], Net benefit: US$ 7313 [US$ 10,496.55] |
| Wang et al. 2008 (USA) [27] | After school program: physical activity, healthy snacks, support with homework, and “academic enrichment” | Children, Elementary school, 6–10 years | School | CEA, using intervention results | Society, 1 year, not stated | % Reduction in body fat | 2003, US$, intervention costs, after-school care costs without intervention | US$ 417 [US$ 509.89] per % point body fat reduction |
| Wang et al. 2011 (USA) [25] | Interdisciplinary approach, lessons, sport materials, wellness, teacher training | Children (6th–8th school year), 11–13 years | School | CUA, using a model approach (calculating additional benefit) | Society, 10 years, costs and benefits both at 3 % | DWCB avoided, QALYs | 2010, US$, total costs | Cost per QALY saved (DWCB and obesity combined) = US$ 2966 [US$ 3060.91], net benefit (DWCB + obesity) = US$ 14,238 [US$ 14,693.62] |
*Results were adjusted to the year 2011 (year of the study with the newest data) using consumer price index (CPI) as part of the Main Economic Indicators (MEI) of the OECD and purchasing power parity (PPP) conversion rate of the year of the latest intervention to convert numerical results to U.S. dollars
AU$ Australian dollar, AUS Australia, CEA cost-effectiveness analysis, CUA cost–utility analysis, DALY disability adjusted life year, DWCB disordered weight control behaviors, EUR Euro, £ Great British pound, MPA moderate physical activity, NHS national health service, NZ New Zealand, NZ$ New Zealand dollar, QALY quality adjusted life year, USA United States of America, US$ U.S. dollar, WC waist circumference, WHtR waist-to-height ratio