Cost-Effectiveness Analysis of a Behavioral Risk Factor Reduction Program at a Worksite: Experience From a Public University in Malaysia
Abstract
Objectives: The objectives of this study were to determine the cost of a behavioral risk factor reduction program at the worksite and to compare the cost-effectiveness of the program with a control group. Methodology: This was a quasi-experimental study conducted among employees of Universiti Sains Malaysia. The program targeted five primary risk factors (RF). Participants in the intervention program were subjected to schedule individualized counseling and seminars during the 6- month follow-up. Participants in the control group underwent health screening. Cost-effectiveness analysis was conducted from the payer’s perspective to determine the cost of 1% increase in proportion of participants who reach ideal targets for the RF. One-way sensitivity analysis was also conducted. Results: A total 136 participants were recruited in this study. At 6-month follow-up, significantly higher proportion of participants in the intervention group reached target for fruit and vegetable intake (P < 0.001) and physical activity (P = 0.017). The costs of the intervention program and control group were estimated to be MYR304.52 (USD92.28) and MYR169.90 (USD51.48) per participant respectively. The incremental cost-effectiveness ratio (ICER) of all the RF were lower than the World Health Organization recommendation based on the CHOICE analyses for relative cost-effectiveness of an intervention. Body mass index and alcohol consumption reported negative ICER which indicated control dominant. Sensitivity analyses showed that ICER was reported to be most sensitive to the change in participants’ salary. Conclusion: The proposed health promotion program was shown to be cost-effective in modifying most of the behavioral RF.