Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults
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...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08294-7 |
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| author | Jaimie-Lee Maple Jaithri Ananthapavan Kylie Ball Megan Teychenne Marj Moodie |
| author_facet | Jaimie-Lee Maple Jaithri Ananthapavan Kylie Ball Megan Teychenne Marj Moodie |
| author_sort | Jaimie-Lee Maple |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-12-12T00:39:25Z |
| format | Article |
| id | doaj.art-dfa5394e3d6e4431a4b777afaafd4892 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-12T00:39:25Z |
| publishDate | 2022-07-01 |
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| spelling | doaj.art-dfa5394e3d6e4431a4b777afaafd48922022-12-22T00:44:18ZengBMCBMC Health Services Research1472-69632022-07-0122111010.1186/s12913-022-08294-7Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adultsJaimie-Lee Maple0Jaithri Ananthapavan1Kylie Ball2Megan Teychenne3Marj Moodie4Institute for Health and Sport, Victoria UniversityDeakin Health Economics, Faculty of Health, Institute for Health Transformation, Deakin UniversityInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin UniversityInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin UniversityDeakin Health Economics, Faculty of Health, Institute for Health Transformation, Deakin UniversityAbstract 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).https://doi.org/10.1186/s12913-022-08294-7Economic evaluationCost-effectivenessPhysical ActivitySedentary BehaviourIncentivisation |
| spellingShingle | Jaimie-Lee Maple Jaithri Ananthapavan Kylie Ball Megan Teychenne Marj Moodie Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults BMC Health Services Research Economic evaluation Cost-effectiveness Physical Activity Sedentary Behaviour Incentivisation |
| title | Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| title_full | Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| title_fullStr | Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| title_full_unstemmed | Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| title_short | Economic evaluation of an incentive-based program to increase physical activity and reduce sedentary behaviour in middle-aged adults |
| title_sort | economic evaluation of an incentive based program to increase physical activity and reduce sedentary behaviour in middle aged adults |
| topic | Economic evaluation Cost-effectiveness Physical Activity Sedentary Behaviour Incentivisation |
| url | https://doi.org/10.1186/s12913-022-08294-7 |
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