WHAT TO CONSIDER WHEN CONDUCTING A COST-EFFECTIVENESS ANALYSIS IN A CLINICAL SETTING

More data are needed providing strong evidence that nutrition services are cost-effective. Economic evaluations, such as cost-effectiveness analyses, are excellent practice-based research projects. We conducted a cost-effectiveness analysis in a clinical setting to compare the co st-effectiveness of lipid-lowering medications plus diet therapy (medi cation+diet) with diet therapy alone (diet alone) for treating patient s with hypercholesterolemia. Twenty-five adults with hypercholesterole mia (13 receiving medication+diet, 12 receiving diet alone) either par ticipated in an 8-week, home-based, step 1 intervention or were counse led about diet and lifestyle by their care provider. Diet, cost, and l aboratory data were collected at baseline, at 9 months, and at 19 mont hs after participation in the intervention (follow-up). Cost per unit change in outcome was evaluated for each group. The diet-alone group m ade only small changes in dietary Intake, changes that were smaller in magnitude than those made by the medication+diet group. Nevertheless, at 9 months, costs per unit change in total serum cholesterol level a nd low-density lipoprotein cholesterol (LDL-C) level were approximatel y $24 and $83 less, respectively, for the diet-alone group. At follow- up, however, the cost per unit change in LDL-C level was approximately $17 less for the medication+diet group, which can be explained by the medication+diet group's greater decrease in LDL-C level. The followin g elements should be considered when conducting a cost-effectiveness a nalysis of medical nutrition therapy: effectiveness of the nutrition i ntervention, adequate sample size, confounding variables, compliance w ith diet and drug therapy, direct and indirect costs of care, and foll ow-up evaluation.