Health economic modelling of overweight and obesity in Australian adolescents

Abstract

Adolescence, defined as the phase of life from 10 years to 19 years of age, is a particularly vulnerable time for the development of overweight and obesity. This is a concern, as the earlier that excess weight is accumulated, the greater the associated morbidity, premature mortality and related costs in later life will be.

As such, adolescence has been identified by policy-makers in Australia as an opportune time to intervene for overweight and obesity prevention and treatment. However, this is just one of many issues for decision-makers to consider within the constraints of finite resources. To make informed judgments for resource allocation, evidence that proposed interventions are cost-effective, or represent ‘value for money’ is required.

While the costs of interventions for adolescent overweight and obesity are incurred up-front, their benefits are not fully realised until many years in the future, beyond what can be captured within a clinical trial. This makes it challenging to demonstrate their ‘value for money’. In these cases, modelling methods are required to estimate the costs and benefits of proposed interventions over longer-term and more policy-relevant timeframes.

This thesis addresses this issue through the development of the Early Prevention of Obesity in CHildhood (EPOCH) Life-course model, a health economic model that can be applied to evaluate interventions for adolescent overweight and obesity in line with current best practice methodologies in Australia.

Further, this thesis applies the EPOCH Life-course model to answer questions which will be of interest to current decision-makers in Australia. This includes demonstrating the economic benefits of a reduction in prevalence of overweight and obesity in Australian children and adolescents and the potential cost-effectiveness of e-health interventions as a possible strategy to achieve this.