Journal of General Internal Medicine

, Volume 28, Issue 12, pp 1581–1588

Economic Analyses of the Be Fit Be Well Program: A Weight Loss Program for Community Health Centers

  • Debra P. Ritzwoller
  • Russell E. Glasgow
  • Anna Y. Sukhanova
  • Gary G. Bennett
  • Erica T. Warner
  • Mary L. Greaney
  • Sandy Askew
  • Julie Goldman
  • Karen M. Emmons
  • Graham A. Colditz
  • For the Be Fit Be Well Study Investigators
Original Research

DOI: 10.1007/s11606-013-2492-3

Cite this article as:
Ritzwoller, D.P., Glasgow, R.E., Sukhanova, A.Y. et al. J GEN INTERN MED (2013) 28: 1581. doi:10.1007/s11606-013-2492-3

ABSTRACT

BACKGROUND

The U.S. Preventive Services Task Force has released new guidelines on obesity, urging primary care physicians to provide obese patients with intensive, multi-component behavioral interventions. However, there are few studies of weight loss in real world nonacademic primary care, and even fewer in largely racial/ethnic minority, low-income samples.

OBJECTIVE

To evaluate the recruitment, intervention and replications costs of a 2-year, moderate intensity weight loss and blood pressure control intervention.

DESIGN

A comprehensive cost analysis was conducted, associated with a weight loss and hypertension management program delivered in three community health centers as part of a pragmatic randomized trial.

PARTICIPANTS

Three hundred and sixty-five high risk, low-income, inner city, minority (71 % were Black/African American and 13 % were Hispanic) patients who were both hypertensive and obese.

MAIN MEASURES

Measures included total recruitment costs and intervention costs, cost per participant, and incremental costs per unit reduction in weight and blood pressure.

KEY RESULTS

Recruitment and intervention costs were estimated $2,359 per participant for the 2-year program. Compared to the control intervention, the cost per additional kilogram lost was $2,204 /kg, and for blood pressure, $621 /mmHg. Sensitivity analyses suggest that if the program was offered to a larger sample and minor modifications were made, the cost per participant could be reduced to the levels of many commercially available products.

CONCLUSIONS

The costs associated with the Be Fit Be Well program were found to be significantly more expensive than many commercially available products, and much higher than the amount that the Centers for Medicare and Medicaid reimburse physicians for obesity counseling. However, given the serious and costly health consequences associated with obesity in high risk, multimorbid and socioeconomically disadvantaged patients, the resources needed to provide interventions like those described here may still prove to be cost-effective with respect to producing long-term behavior change.

KEY WORDS

weight lossRCTpragmatic trialcostcost-effectivenesshealth disparities

Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Debra P. Ritzwoller
    • 1
  • Russell E. Glasgow
    • 2
  • Anna Y. Sukhanova
    • 1
  • Gary G. Bennett
    • 3
    • 4
  • Erica T. Warner
    • 5
    • 6
  • Mary L. Greaney
    • 6
  • Sandy Askew
    • 4
  • Julie Goldman
    • 6
  • Karen M. Emmons
    • 6
    • 7
  • Graham A. Colditz
    • 5
    • 8
  • For the Be Fit Be Well Study Investigators
  1. 1.Institute for Health Research, Kaiser Permanente ColoradoDenverUSA
  2. 2.Division of Cancer Control and Population Sciences, National Cancer InstituteBethesdaUSA
  3. 3.Department of Psychology and NeuroscienceDuke UniversityDurhamUSA
  4. 4.Duke Global Health InstituteDuke UniversityDurhamUSA
  5. 5.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  6. 6.Center for Community Based Research, Division of Population Sciences, Dana Farber Cancer InstituteBostonUSA
  7. 7.Department of Society, Human Development and HealthHarvard School of Public HealthBostonUSA
  8. 8.Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer CenterWashington University School of MedicineSt LouisUSA