The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation.

The cost-effectiveness of work-site wellness programs for reducing cardiovascular disease risks of employees was examined at three manufacturing plants. A fourth plant was used as a control site to estimate levels of risk reduction achieved from wellness screening and preexisting services, without further interventions. The cardiovascular disease risks included in the study were hypertension, obesity, and cigarette smoking. The annual direct cost per employee for postscreening interventions was $2.97 for site 1 (control site), $17.68 for site 2 (health education), $30.96 for site 3 (health education plus follow-up counseling), and $38.31 for site 4 (health education, follow-up counseling plus plant organization for health promotion). Of the three experimental sites, sites 3 and 4 were more effective and more cost-effective than was site 2, both in terms of engaging employees at risk of cardiovascular disease into treatment or program participation and of reducing their risks or preventing relapse. For engaging employees into treatment/program participation, sites 3 and 4 were nine to ten times more cost-effective than was site 2; for reducing risks/preventing relapse, sites 3 and 4 were five to six times more cost-effective than was site 2. At sites 3 and 4, the total direct cost per percent of risks reduced/relapse prevented was less than one dollar ($.67 and $.74, respectively) per employee per year. Program costs may vary considerably across companies because of differences in salary structures and overhead costs. These are held constant in this report for comparison across program models.