The prevention of eating disorders in Australian adolescents: a modeled cost-effectiveness study

Objective: Prevention programs for eating disorders (EDs) have the potential to reduce the onset of these diseases and improve the mental health and well-being of the general population. However, there is mixed evidence on whether routine implementation of such programs at the population level is cost-effective. This study intends to investigate the cost-effectiveness of an evidence-based preventive intervention for EDs, the Body Project, at the population level. Method: The Body Project is a targeted school-based intervention that aims to prevent EDs among adolescents. A Markov model was developed to evaluate the incremental cost-effectiveness of the hypothetical implementation of the Body Project among female-identifying secondary students in Australia versus a ‘no intervention’ comparator. A cost-utility analysis was conducted from a “healthcare and limited education” sector perspective with costs and health impacts modeled over the lifetime of the target population. An incremental cost-effectiveness ratio (ICER), expressed as cost per health-adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions. Results: If implemented across 1416 Australian secondary schools, the modeled Body Project consisting of four group sessions for eligible girls aged 15–18 years with high body image concerns was estimated to yield about 92 HALYs (95% CI: 58–131) and save $2.56 million in future healthcare costs at an implementation cost of $1.88 million (95% CI: $1.62–$2.15 million). Discussion: The Body Project intervention is likely to represent good value for money. Successful implementation of this program will require further research into its feasibility and acceptability among schools and the wider community.