title: Cost-effectiveness of exercise programs in type 2 diabetes.
abstract: BACKGROUND
  A randomized controlled trial has shown that supervised, facility-based exercise training is effective in improving glycemic control in type 2 diabetes. However, these programs are associated with additional costs. This analysis assessed the cost-effectiveness of such programs.
  
  
  METHODS
  Analysis used data from the Diabetes Aerobic and Resistance Exercise (DARE) clinical trial which compared three different exercise programs (resistance, aerobic or a combination of both) of 6 months duration with a control group (no exercise program). Clinical outcomes at 6 months were entered for individual patients into the UKPDS economic model for type 2 diabetes adapted for the Canadian context. From this, expected life-years, quality-adjusted life-years (QALYs) and costs were estimated for all patients within the trial.
  
  
  RESULTS
  The combined exercise program was the most expensive ($40,050) followed by the aerobic program ($39,250), the resistance program ($38,300) and no program ($31,075). QALYs were highest for combined (8.94), followed by aerobic (8.77), resistance (8.73) and no program (8.70). The incremental cost per QALY gained for the combined exercise program was $4,792 compared with aerobic alone, $8,570 compared with resistance alone, and $37,872 compared with no program. The combined exercise program remained cost-effective for all scenarios considered within sensitivity analysis.
  
  
  CONCLUSIONS
  A program providing training in both resistance and aerobic exercise was the most cost-effective of the alternatives compared. Based on previous funding decisions, exercise training for individuals with diabetes can be considered an efficient use of resources.
authors.affiliation: University of Ottawa, Ontario, Canada. dcoyle@uottawa.ca
authors.forename: Doug
authors.initials: D
authors.lastname: Coyle
authors.forename: Kathryn
authors.initials: K
authors.lastname: Coyle
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.forename: Normand G
authors.initials: NG
authors.lastname: Boulé
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.forename: Michelle
authors.initials: M
authors.lastname: Fortier
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reid
authors.forename: Penny
authors.initials: P
authors.lastname: Phillips
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sigal
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055070:Resistance Training / Q000191:economics*; D006113:United Kingdom