Assessing Value of Behavioral Interventions: Designing Cost-Effectiveness Analyses for Food-Is-Medicine Interventions

Top Things to Know

FIM interventions should be assessed using the same cost-effectiveness standards applied to medications, devices, and other healthcare services, rather than being held to a higher expectation of cost savings alone.

Researchers should collect data beyond healthcare utilization, including quality of life, participant time, productivity, spillover effects on family members, and equity impacts.

Standardized economic evaluation methods and long-term simulation models could make it easier to compare findings across FIM studies and strengthen the evidence base needed for payer coverage and reimbursement decisions.

Summary of Conclusion/Findings

This methodological paper provides guidance on how to design and conduct cost-effectiveness analyses (CEAs) for food is medicine (FIM) interventions, including medically tailored meals, medically tailored groceries, and produce prescriptions, as the evidence base for these programs continues to expand. The authors argue that FIM interventions should be evaluated using the same value framework applied to other healthcare interventions, focusing on whether they generate meaningful health gains at a reasonable incremental cost rather than whether they produce net savings. They recommend that economic evaluations consistently measure intervention costs, healthcare utilization, health-related quality of life, and quality-adjusted life-years (QALYs), while also considering broader societal outcomes such as productivity, educational attainment, caregiver impacts, and health equity. The paper emphasizes that many FIM studies have short follow-up periods and therefore often require modeling approaches to project long-term health and economic outcomes from intermediate measures such as blood pressure, hemoglobin A1c, or hospitalization rates. The authors also highlight the importance of accounting for participant burden, family spillover effects, and equity considerations because FIM programs frequently serve populations disproportionately affected by diet-related disease. Ultimately, they conclude that rigorous, standardized, and comparable economic evaluations could help generate the evidence needed to support broader payer coverage of cost-effective FIM interventions.