Cost utility analysis of physical activity counselling in general practice.
OBJECTIVE
To evaluate the economic performance of the 'Green Prescription' physical activity counselling program in general practice.


METHODS
Cost utility analysis using a Markov model was used to estimate the cost utility of the Green Prescription program over full life expectancy. Program effectiveness was based on published trial data (878 inactive patients presenting to NZ general practice). Costs were based on detailed costing information and were discounted at 5% per anum. The main outcome measure is cost per quality adjusted life year (QALY) gained. Extensive one-way sensitivity analyses were performed along with probabilistic (stochastic) analysis.


RESULTS
Incremental, modelled cost utility of the Green Prescription program compared with 'usual care' was dollar NZ2,053 per QALY gained over full life expectancy (range dollar NZ827 to dollar NZ37,516 per QALY). Based on the probabilistic sensitivity analysis, 90% of ICERs fell below dollar NZ7,500 per QALY.


CONCLUSIONS
Based on a plausible and conservative set of assumptions, if decision makers are willing to pay at least dollar NZ2,000 per QALY gained the Green Prescription program is likely to represent better value for money than 'usual care'.


CONCLUSIONS
The Green Prescription program performs well, representing a good buy relative to other published cost effectiveness estimates. Policy makers should consider encouraging general practitioners to prescribe physical activity advice in the primary care setting, in association with support from exercise specialists.
Dalziel
Kim
K
Centre for Health Economics, Faculty of Business and Economics, Building 75, Clayton Campus, Monash University, Wellington Rd, Clayton, Victoria 3800. Kim.Dalziel@buseco.monash.edu.au
Segal
Leonie
L
Elley
C Raina
CR
D000328:Adult; D000368:Aged; D003376:Counseling / Q000191:economics* / Q000458:organization & administration; D015444:Exercise; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009520:New Zealand; D015397:Program Evaluation / Q000191:economics; D019057:Quality-Adjusted Life Years