Prof Nick Wilson, Dr Cristina Cleghorn, Dr Linda Cobiac, Dr Anja Mizdrak, Prof Cliona Ni Mhurchu, Prof Tony Blakely
In this blog we consider recent literature (particularly reviews) on the effectiveness and cost-effectiveness of dietary counselling as a health intervention. Most studies suggest that dietary counselling is effective though the benefits are typically modest and short-term. The literature on cost-effectiveness is mixed, and there is substantial uncertainty about long-run cost-effectiveness given the typically short-term trials involved. Addressing the obesogenic environment will have potentially (much) larger gains, and due to substantial reductions in obesity-related disease it is likely to be cost-saving. However, governments, policy-makers and the public are often interested in counselling interventions, necessitating close attention to cost-effectiveness of these interventions relative to more structural changes to the environment.
Prof Nick Wilson, Dr Giorgi Kvizhinadze, Dr Eamonn Deverall, Prof Tony Blakely
A just published modelling study by the BODE3 Team has reported that “home safety assessment and modification” (e.g., adding hand rails and removing tripping hazards in homes) appears to be a very cost-effective health sector intervention. But even more cost-effective was targeting this intervention to older people with previous injurious falls. In this blog we take a closer look at this intervention and consider what policy-makers, NGOs and citizens might wish to consider doing in response to the evidence.
By the BODE3 Programme Team*
In this blog we describe an online calculator we developed to estimate the maximum investment society might consider spending on life-saving health interventions, while remaining cost-effective. For NZ, the amounts generated by this calculator vary greatly by age: NZ$ 1.2 million for an intervention to save the life of a child, NZ$ 0.7 million for a 50-year-old, and NZ$ 0.2 million for an 80-year-old, assuming we are willing to spend $45,000 per healthy life-years gained and the person is returned to the expected health status of the average NZ citizen. These results are very sensitive to the choice of discount rate and to the selected cost-effectiveness threshold. Policy-makers could use this calculator as a rapid screening tool to determine if more detailed cost-effectiveness analyses of potential life-saving interventions might be worthwhile.
Associate Professor Nick Wilson, Professor Tony Blakely
A recently published review has quantified the estimated benefits and harms of taking regular aspirin for disease prevention. The results indicate a relatively favourable benefit-to-harm ratio (good for preventing various cancers and heart attacks – but also harmful in terms of causing gastric bleeding and one type of stroke). But for some people, the relative size of the benefit may still not be enough to outweigh the dislike of taking daily medication. This blog briefly looks at the issues and considers possible responses by NZ health agencies and research funders.
Associate Professor Nick Wilson
The recently published Report on the safety of water fluoridation (Royal Society of NZ & the Office of the Prime Minister’s Chief Science Advisor) gave a green light for expanding water fluoridation in New Zealand given the scientific evidence for health benefit and safety, reduction in inequalities in oral health, and the cost-effectiveness. This blog post goes further to explore what else could be done to maximise the benefits of fluoridation for the oral health of New Zealanders.