Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment.
OBJECTIVE
To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK.


METHODS
Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value.


RESULTS
Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society.


CONCLUSIONS
Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.
Health Economics Unit, Public Health Building, University of Birmingham, Birmingham, UK.
Emma J
EJ
Frew
Mobeen
M
Bhatti
Khine
K
Win
Alice
A
Sitch
Anna
A
Lyon
Miranda
M
Pallan
Peymane
P
Adab
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D004739:England; D015444:Exercise / Q000502:physiology*; D005249:Fees and Charges; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D014504:Urban Health; D055815:Young Adult