Table 4.
Results of one-way deterministic sensitivity analyses on the lifetime cost per QALY gained
| Time period | Parameters | Healthcare perspective | Societal perspective | ||
|---|---|---|---|---|---|
| PAS vs control schools | HPSF vs control schools | ||||
| Reference scenario (deterministic results: Total net cost / Total QALYs gained) | €58,698 | €19,734 | |||
| lower | upper | lower | upper | ||
| Childhood & adolescence | Two-year intervention effects (+/− 20%) | €57,581 | €59,619 | €19,319 | €20,061 |
| Effect maintenance factors (+/− 20%) | €51,934 | €62,020 | €17,782 | €20,977 | |
| Intervention costs (+/− 20%) | €48,807 | €68,588 | €16,150 | €23,317 | |
| HRQOL weights (+/− 20%) | €57,546 | €59,897 | €19,338 | €20,146 | |
| Ratio of HC costs for overweight and obesity vs. normal weight (+/− 20%) | €58,649 | €58,747 | €19,683 | €19,784 | |
| Ratio of school absenteeism days for overweight and obesity vs. normal weight (+/− 20%) | – | €19,599 | €19,868 | ||
| HRQOL based on the quasi-experimental study a | €60,612 | €20,390 | |||
| Ratio of HC costs for overweight and obesity vs. normal weight based on the quasi-experimental study | €58,603 | €19,637 | |||
| Ratio of school absenteeism days for overweight and obesity vs. normal weight based on the quasi-experimental study | – | €19,756 | |||
| Adulthood | HRQOL determined by weight category instead of by chronic disease in adulthood | €36,397 | €12,273 | ||
| Sick leave days for overweight and obesity vs. normal weight (+/− 20%) | – | €18,285 | €25,779 | ||
| Time horizon until age 70 years | €156,646 | €79,523 | |||
| Inclusion on short-term intervention costs (year 1 and 2) instead of estimated long-run costs only | €67,423 | €32,649 | |||
| Discount rates of 3% for both costs and effects | €183,687 | €31,230 | |||
Notes: HPSF the Healthy Primary School of the Future, PAS the Physical Activity School
Costs discounted at 4% and effects discounted at 1.5% per year
a We found no overall trend in utility decrements for overweight and obesity in the quasi-experimental study. Brown et al. (2018) also report that evidence on utility decrements in young children is inconclusive. No utility decrements were applied during the primary school period