Cost Analysis of Personalized Intensive Lifestyle Modification for NCD Risk Populations in Thailand

Abstract

Background: Non-communicable diseases (NCDs) remain the leading cause of morbidity, mortality, and healthcare expenditure in Thailand, yet real-world cost evidence for personalized intensive lifestyle interventions is limited. Objective: To estimate the cost of implementing the Personalized Intensive Lifestyle Modification Program (PILM) for populations at risk of NCDs in Thailand. Methods: A cross-sectional retrospective cost analysis was conducted using an activitybased costing approach from the provider perspective. Fiscal year 2023 cost data were collected from 12 service settings (hospitals, municipal health facilities, and public institutions). Core PILM components delivered across settings included baseline risk assessment, individualized lifestyle counseling/coaching, structured diet and physical activity planning, and continuous follow-up via face-to-face visits and digital communication. Costs were classified as labor, material, and capital. Unit cost per participant was calculated for a six-month program cycle and reported in U.S. dollars. Results: A total of 477 participants received PILM services across 12 settings. Labor accounted for 63% of total cost, followed by capital (29%) and material (8%). The mean unit cost was USD 83 per participant (range: USD 24.97–156.71). Conclusion: PILM implementation costs varied across settings, with labor as the primary cost driver. These findings support budgeting and service design for integrating personalized NCD prevention into Thailand’s universal health coverage.