Bibliographic Details
| Title: |
Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| Authors: |
Jaimie-Lee Maple, Jaithri Ananthapavan, Kylie Ball, Megan Teychenne, Marj Moodie |
| Source: |
BMC Health Services Research, Vol 22, Iss 1, Pp 1-10 (2022) |
| Publisher Information: |
BMC, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Public aspects of medicine |
| Subject Terms: |
Economic evaluation, Cost-effectiveness, Physical Activity, Sedentary Behaviour, Incentivisation, Public aspects of medicine, RA1-1270 |
| More Details: |
Abstract Background Incentive-based programs represent a promising approach for health insurers to encourage health-promoting behaviours. However, little is known about the value for money of such programs. This study aimed to determine the cost-effectiveness of the ACHIEVE (Active CHoices IncEntiVE) program designed to incentivise increased physical activity and reduced sedentary behaviour in middle-aged adults. Methods A within-trial cost-efficacy analysis was conducted. Benefits were assessed by evaluating paired t-tests from participants’ pre- and post- trial Body Mass Index (BMI) (kg/m2), sitting time (minutes/day) and metabolic equivalents (METS) minutes. A health sector perspective was adopted for the assessment of costs. Pathway analysis was used to determine the resource use associated with the intervention, with costs expressed in Australian dollars (A$) for the 2015 reference year. A long-term cost-effectiveness analysis was undertaken which extended the analysis time horizon and the trial population to the relevant eligible Australian population. Within this analysis, the 16-week intervention was modelled for roll-out across Australia over a 1-year time horizon targeting people with private health insurance who are insufficiently active and highly sedentary. Improved health related quality of life quantified in Health-Adjusted Life Years (HALYs) (based on the health impacts of increased metabolic equivalent (MET) minutes and reduced body mass index (BMI) and cost-offsets (resulting from reductions in obesity and physical inactivity-related diseases) were tracked until the cohort reached age 100 years or death. A 3% discount rate was used and all outcomes were expressed in 2010 values. Simulation modelling techniques were used to present 95% uncertainty intervals around all outputs. Results The within-trial cost-efficacy analysis indicated that the ACHIEVE intervention cost approximately A$77,432. The cost per participant recruited was A$944. The incremental cost-effectiveness ratio (ICER) for MET increase per person per week was A$0.61; minute of sedentary time reduced per participant per day was A$5.15 and BMI unit loss per participant was A$763. The long-term cost effectiveness analysis indicated that if the intervention was scaled-up to all eligible Australians, approximately 265,095 participants would be recruited to the program at an intervention cost of A$107.4 million. Health care cost savings were A$33.4 million. Total HALYs gained were 2,709. The mean ICER was estimated at A$27,297 per HALY gained which is considered cost-effective in the Australian setting. Conclusion The study findings suggest that financial incentives to promote physical activity and reduce sedentary behaviour are likely to be cost-effective. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12616000158460 (10/02/2016). |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1472-6963 |
| Relation: |
https://doaj.org/toc/1472-6963 |
| DOI: |
10.1186/s12913-022-08294-7 |
| Access URL: |
https://doaj.org/article/dfa5394e3d6e4431a4b777afaafd4892 |
| Accession Number: |
edsdoj.fa5394e3d6e4431a4b777afaafd4892 |
| Database: |
Directory of Open Access Journals |
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