Five-year cost-effectiveness analysis of the European Fans in Training (EuroFIT) physical activity intervention for men versus no intervention

Kolovos, S. et al. (2020) Five-year cost-effectiveness analysis of the European Fans in Training (EuroFIT) physical activity intervention for men versus no intervention. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 30. (doi: 10.1186/s12966-020-00934-7)

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Abstract

Objectives: Increasing physical activity reduces the risk of chronic illness including Type 2 diabetes, cardiovascular disease and certain types of cancer. Lifestyle interventions can increase physical activity but few successfully engage men. This study aims to investigate the 5 year cost-effectiveness of EuroFIT, a program to improve physical activity tailored specifically for male football (soccer) fans compared to a no intervention comparison group. Methods: We developed a Markov cohort model in which the impact of improving physical activity on five chronic health conditions (colorectal cancer, Type 2 diabetes, coronary heart disease, stroke and depression) and mortality was modelled. We estimated costs from a societal perspective and expressed benefits as quality adjusted life years (QALYs). We obtained data from a 4-country (England, Netherlands, Portugal and Norway) pragmatic randomised controlled trial evaluating EuroFIT, epidemiological and cohort studies, and meta-analyses. We performed deterministic and probabilistic sensitivity analyses to assess the impact of uncertainty in the model’s parameter values on the cost-effectiveness results. We used Monte Carlo simulations to estimate uncertainty and presented this using cost-effectiveness acceptability curves (CEACs). We tested the robustness of the base case analysis using five scenario analyses. Results: Average costs over 5 years per person receiving EuroFIT were €14,663 and per person receiving no intervention €14,598. Mean QALYs over 5 years were 4.05 per person for EuroFIT and 4.04 for no intervention. Thus, the average incremental cost per person receiving EuroFIT was €65 compared to no intervention, while the average QALY gain was 0.01. This resulted in an ICER of €5206 per QALY gained. CEACs show that the probability of EuroFIT being cost-effective compared to no intervention is 0.53, 0.56 and 0.58 at thresholds of €10,000, €22,000 and €34,000 per QALY gained, respectively. When using a time horizon of 10 years, the results suggest that EuroFIT is more effective and less expensive compared to (i.e. dominant over) no intervention with a probability of cost-effectiveness of 0.63 at a threshold of €22,000 per QALY gained. Conclusions: We conclude the EuroFIT intervention is not cost-effective compared to no intervention over a period of 5 years from a societal perspective, but is more effective and less expensive (i.e. dominant) after 10 years. We thus suggest that EuroFIT can potentially improve public health in a cost-effective manner in the long term.

Item Type:Articles
Additional Information:This project has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement number 602170.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and Gray, Professor Cindy and Gill, Professor Jason and Bunn, Dr Christopher
Authors: Kolovos, S., Finch, A. P., van der Ploeg, H. P., van Nassau, F., Broulikova, H. M., Baka, A., Treweek, S., Gray, C. M., Jelsma, J. G.M., Bunn, C., Roberts, G. C., Silva, M. N., Gill, J. M.R., Røynesdal, Ø., van Mechelen, W., Andersen, E., Hunt, K., Wyke, S., and Bosmans, J. E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:International Journal of Behavioral Nutrition and Physical Activity
Publisher:BioMed Central
ISSN:1479-5868
ISSN (Online):1479-5868
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in International Journal of Behavioral Nutrition and Physical Activity 17(1):30
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190675EUROFIT: Social innovation to improve physical activity and sedentary behaviour through elite European footballSally WykeEuropean Commission (EC)602170S&PS - Institute of Health & Wellbeing (Social Sciences)