Is personalised nutrition an effective tool for preventing diet related diseases considering potentially higher costs?
Nowadays, many people suffer from the well-known global health problem called obesity. Obesity is often caused by poor dietary patterns, which might lead to different diet related diseases, such as type 2 diabetes and heart diseases [1] [2]. Thus, prevention of poor dietary patterns might help to reduce these kinds of diseases and thereby improve health outcomes.
There is much attention for developing nutrition interventions, such as dietary apps, targeting poor dietary patterns. Besides that, an increasing number of people believe that these interventions are probably more effective when focusing on the individual variability in nutritional needs instead of the overall population [2] [3]. Personalisation of such interventions might therefore improve health outcomes.
However, new techniques like personalisation will probably cost more at the start of such an intervention. Therefore, the question is whether the improved effects due to the personalisation, might outweigh the increasing costs?
A literature review to evaluate the cost-effectiveness of personalised nutrition
For the PREVENTOMICS project we find important to discover more about the field of personalised interventions and its related effects and costs. We therefore conducted a systematic literature review to evaluate the costs and effects of these type of interventions, so-called cost-effectiveness analysis.
There were 49 studies that performed a cost-effectiveness analysis about personalised nutrition interventions. When looking into more detail at the 49 cost-effectiveness analyses, we saw a discrepancy in the type of interventions studied.
Almost 50 studies performed a cost-effectiveness analysis of a personalised nutrition intervention, that were based on different intervention criteria.
There were studies that personalised their intervention based on current eating habits, behaviour and preferences; also called the psychological concept of personalised nutrition. On the other hand, there were interventions based on the biological evidence of differential responses to foods/nutrients such as biomarkers, genotype and microbiota [1] [3]. A combination of these two concepts might be the optimal solution for an effective nutrition intervention.
However, we didn’t find many studies who investigate this combination and the large majority (89%) focused on the psychological forms of personalized nutrition only. Moreover, we found that most authors (51%) concluded that their intervention was cost-effective.
The importance of cost-effectiveness analysis
PREVENTOMICS will focus on the integration of both personalised nutrition concepts and will investigate its related health outcomes and costs. Before an intervention is ready to be implemented on to the market, it is important to know whether the interventions are effective. Clinical outcomes can be essential, such as a decrease in waist circumferences or BMI. Also measuring the quality of life of patients may be important because this might increase due to an improvement in health. Moreover, it is important to know whether the costs are not too high.
Assuring that the solution costs are not too high is as essential as any other clinical objective
Combining these health outcomes and costs in a cost-effectiveness analysis will give a good overview of whether an intervention is cost-effective. If the intervention seems to be cost-effective, it is important to look at who is going to pay for this new intervention. Is it the user or could there be a third party who will cover all or a part of the costs?
These questions will all be answered within the PREVENTOMICS project. Furthermore, it is important to understand how patients view the interventions and what kind of personalisation they like the most. What are they willing to pay for home delivery of their meals compared to only recipe recommendations? Do they prefer an intervention with more health improvement, or do they prefer interventions that take less time?
All will be answered within the PREVENTOMICS project.
Authors
Milanne Galekop
PhD student in Health Technology Assessment at the Erasmus School of Health Policy and Management at the Erasmus University in Rotterdam. She has a background in Health Economics and her PhD research focuses on the PREVENTOMICS project and the cost-effectiveness of the different interventions.
Ken Redekop, Ph.D.
Associate professor at the Health Technology Assessment, Erasmus University Rotterdam, The Netherlands. He is a clinical epidemiologist with more than 20 years of experience in observational research, clinical trial analysis, and medical technology assessment and an author of over 100 papers in the medical literature. Current studies include early-stage cost-effectiveness analyses of medical devices and tests, RCT-based economic evaluations, economic evaluations in the Diagnostics Assessment programme of the National Institute for Health and Clinical Excellence (NICE, UK) and outcomes research studies to determine the effectiveness and cost-effectiveness of expensive medicines in daily practice. Most studies relate to diabetes, cardiovascular disease, and cancer, and most involve modelling and evidence synthesis.
References
[1] Ordovas JM, Ferguson LR, Tai ES, Mathers JC. Personalised nutrition and health. BMJ. 2018;361:1-7. doi:10.1136/bmj.k2173
[2] Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: A 21st century challenge. Lancet Diabetes Endocrinol. 2014;2(1):56-64. doi:10.1016/S2213-8587(13)70112-8
[3] Biesiekierski JR, Livingstone KM, Moschonis G. Personalised nutrition: Updates, gaps and next steps. Nutrients. 2019;11(8):10-14. doi:10.3390/nu11081793
