Cost-effectiveness of a cardiovascular disease risk reduction program aimed at financially vulnerable women: The Massachusetts WISEWOMAN Project

Objective: The Massachusetts WISEWOMAN Project is a cardiovascular disease (CVD) risk reduction program targeting older uninsured and underinsured women. The cost-effectiveness of providing CVD screening and enhanced lifestyle interventions (EI), compared with providing CVD screening and a minimum intervention (MI), was assessed at five El and six MI healthcare sites. Methods: Cost calculations were based on data collected during screenings and intervention activities conducted with 1586 women in 1996. Risk factor data, including cholesterol and blood pressure measures, were used to create a summary effectiveness outcome, the 10-year probability of developing coronary heart disease (CHD). The cost-effectiveness ratio of the El, compared with the MI, was calculated by dividing the incremental cost of the EI by the incremental effectiveness of the El. Results: The incremental cost of the EI was $191. During the 1-year study period, the 10-year probability of CHD decreased from 9.4% to 9.2% in the MI group and from 10.3% to 9.8% in the El group. Based on these results, it would cost $637 to achieve a 1 percentage point larger decrease in the 10-year probability of CHD for women enrolled in the El. However, because differences between groups were not statistically significant, we cannot reject the hypothesis that the El results in no greater reductions in CHD risk. Conclusions: Although women enrolled in both the MI and El showed decreases in CHD risk during the study period, future research is needed to assess the impact of lifestyle interventions targeting financially disadvantaged women.