Cost-effectiveness of incentives for physical activity in coronary heart disease in Germany: pre-trial health economic model of a complex intervention following the new MRC framework.
BMJ Open Sport Exerc Med
; 10(2): e001896, 2024.
Article
em En
| MEDLINE
| ID: mdl-38808264
ABSTRACT
Objectives:
The German Incentives for Physical Activity in Cardiac Patients trial is a three-arm, randomised controlled trial for secondary prevention of coronary heart disease (CHD). Guidance for developing complex interventions recommends pre-trial health economic modelling. The aim of this study is to model the long-term cost-effectiveness of the incentive-based physical activity interventions in a population with CHD.Methods:
A decision-analytical Markov model was developed from a health services provider perspective, following a cohort aged 65 years with a previous myocardial infarction for 25 years. Monetary and social incentives were compared relative to no incentive. Intervention effects associated with physical activity were used to determine the costs, quality-adjusted life-years (QALYs) gained, incremental cost-effectiveness and cost-utility ratios. The probability of cost-effectiveness was calculated through sensitivity analyses.Results:
The incremental QALYs gained from the monetary and social incentives, relative to control, were respectively estimated at 0.01 (95% CI 0.00 to 0.01) and 0.04 (95% CI 0.02 to 0.05). Implementation of the monetary and social incentive interventions increased the costs by 874 (95% CI 744 to 1047) and 909 (95% CI 537 to 1625). Incremental cost-utility ratios were 25 912 (95% CI 15 056 to 50 210) and 118 958 (95% CI 82 930 to 196 121) per QALY gained for the social and monetary incentive intervention, respectively. With a willingness-to-pay threshold set at 43 000/QALY, equivalent to the per-capita gross domestic product in Germany, the probability that the social and monetary incentive intervention would be seen as cost-effective was 95% and 0%, respectively.Conclusions:
Exercise-based secondary prevention using inventive schemes may offer a cost-effective strategy to reduce the burden of CHD.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
BMJ Open Sport Exerc Med
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Alemanha