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. 2025 May 1;8(5):e2510087.
doi: 10.1001/jamanetworkopen.2025.10087.

Estimated Costs and Cost-Effectiveness of a Pediatric Weight Management Program

Meg Simione  1   2 , Sophie Wagner  3 , Caroline J Kistin  4 , Kelsey A Egan  5 , Sheila Kelly  1 , William G Adams  5 , Elsie M Taveras  1   2 , Chin Hur  3
Affiliations

Estimated Costs and Cost-Effectiveness of a Pediatric Weight Management Program

Meg Simione et al. JAMA Netw Open. .

Abstract

Importance: Childhood obesity remains a significant public health challenge, with ongoing racial, ethnic, and socioeconomic disparities in its prevention and treatment. Economic evaluations of pediatric obesity interventions are essential for guiding resource allocation in health care settings.

Objective: To develop and analyze a simulation model of the Connect for Health program to estimate the costs of implementing the program and assess its cost-effectiveness.

Design, setting, and participants: This economic evaluation used a Markov cohort model based on the Connect for Health randomized clinical trial (RCT) conducted from June 2014 through March 2016 and the Connect for Health implementation study conducted at 2 academic medical centers in Boston, MA. The study first estimated costs of implementation for new sites, and then simulated program implementation in a cohort that mirrored the RCT population. Data were analyzed from October 2023 to March 2025.

Exposure: The Connect for Health pediatric weight management program.

Main outcomes and measures: Outcomes include costs associated with program implementation and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained.

Results: This study used a cohort of 2494 individuals to mirror the RCT population and included 1178 female participants (47%), a mean (SD) age of 8.0 (3.0) years, and a mean (SD) body mass index z score of 1.91 (0.56). The costs of implementing the Connect for Health program in primary care settings were estimated at $58 000 in 1-time startup costs and $1300 in ongoing monthly costs. The economic model showed that the Connect for Health strategy had an ICER of $10 554 per QALY gained over 2 years compared with no intervention. The study found a threshold of 534 children in a cohort was needed to effectively amortize costs.

Conclusions and relevance: In this economic evaluation of a pediatric weight management program, the Connect for Health program was estimated to be cost-effective. These findings are important for health care systems that serve children who are less likely to receive obesity-related care in making decisions about program adoption.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure.
Figure.. Connect for Health Weight Management Program 1-Way Sensitivity Analysis Results, No Intervention vs Connect for Health
When patient population size decreases to fewer than 534 participants in the Connect for Health program, the incremental cost-effectiveness ratio (ICER) exceeds the willingness-to-pay (WTP) threshold, rendering the program not cost-effective when all other parameters remain constant. ICERs were $263 209 for population size, $185 745 for body mass index (BMI)–associated utility gain, $22 824 for BMI z score change at 1 year, $15 181 for BMI z score change at 2 years, $14 063 for program initial cost, and $12 321 for program continuing cost. The expected value is $10 554. QALY indicates quality-adjusted life-year.
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