Cost-effectiveness and cost-benefit of a lifestyle intervention for workers in the construction industry at risk for cardiovascular disease

OBJECTIVE: To investigate the cost-effectiveness and cost-benefit of a lifestyle intervention for construction workers with an elevated risk of cardiovascular disease. METHODS: In this randomized controlled trial, usual care was compared to a 6-month individual-based lifestyle intervention. At 6 and 12 months, weight, absenteeism, health care use, and lifestyle-related expenses were determined. Missing data were imputed. A cost-effectiveness analysis was performed from a societal perspective. Uncertainty around the incremental cost-effectiveness ratio (ICER) was estimated by bootstrapped cost-effect pairs. A cost-benefit analysis was performed from an employer's perspective, subtracting the incremental costs from the incremental benefits. RESULTS: The ICER was €145/kg weight loss. The difference between intervention and control group in net employer costs was €254 (95% CI: -1070 to 1536). CONCLUSION: Implementation of this important and effective intervention depends on the societal and employer's willingness to pay. ©2011The American College of Occupational and Environmental Medicine.