Does age modify the cost-effectiveness of community-based physical activity interventions?
BACKGROUND
Community-based efforts to promote physical activity (PA) in adults have been found to be cost-effective in general, but it is unknown if this is true in middle-age specifically. Age group-specific economic evaluations could help inform the design and delivery of better and more tailored PA promotion.


METHODS
A Markov model was developed to estimate the cost-effectiveness (CE) of 7 exemplar community-level interventions to promote PA recommended by the Guide to Community Preventive Services, over a 20-year horizon. The CE of these interventions in 25- to 64-year-old adults was compared with their CE in middle-aged adults, aged 50 to 64 years. The robustness of the results was examined through sensitivity analyses.


RESULTS
Cost/QALY (quality-adjusted life year) of the evaluated interventions in 25- to 64-year-olds ranged from $42,456/QALY to $145,868/QALY. Interventions were more cost-effective in middle-aged adults, with CE ratios 38% to 47% lower than in 25- to 64-year-old adults. Sensitivity analyses showed greater than a 90% probability that the true CE of 4 of the 7 interventions was below $125,000/QALY in adults aged 50 to 64 years.


CONCLUSIONS
The exemplar PA promotion interventions evaluated appeared to be especially cost-effective for middle-aged adults. Prioritizing such efforts to this age group is a good use of societal resources.
Larissa
L
Roux
Mike
M
Pratt
I-Min
IM
Lee
Terry
T
Bazzarre
David
D
Buchner
D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D015444:Exercise; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D009043:Motor Activity; D011788:Quality of Life; D019057:Quality-Adjusted Life Years