Cost‐Effectiveness of Two Iterations of a Community‐Based Cardiovascular Disease Prevention Intervention

Objective This study aimed to conduct cost analysis (CA) and cost‐effectiveness analysis (CEA) of Strong Hearts, Healthy Communities (SHHC) implemented in two randomized trials. Methods Women with obesity or women who were sedentary with overweight who were ≥ 40 years old from rural medically underserved towns were randomized to SHHC intervention or control. CA calculated total and per participant costs and opportunity costs. CEA compared incremental costs to incremental outcome changes. Quality‐adjusted life year (QALY) CEA compared incremental costs and effectiveness of a national SHHC intervention for a hypothetical cohort of 2.2 million women. Results SHHC‐1.0 resource cost was $775/participant and SHHC‐2.0 was $747. The incremental cost‐effectiveness ratio from the payer's perspective for SHHC‐1.0 was $346/kg weight loss and $187 and $155 for SHHC‐2.0 at 24 and 48 weeks, respectively. Over a 10‐year horizon, to avert QALYs lost, SHHC‐1.0 was estimated to cost $238,271 from the societal perspective and $62,646 from the health care sector perspective. For SHHC‐2.0, the corresponding numbers were $214,257 and $67,747 at 24 weeks and $94,395 and $11,341 at 48 weeks. Conclusions SHHC‐2.0 compared favorably to SHHC‐1.0 and could be cost‐effective for longer‐term effects. Results can help guide policy makers' decisions on larger‐scale community‐based obesity and cardiovascular disease prevention interventions. Trial Registration ClinicalTrials.gov identifier NCT03059472