title: Economic evaluation of a falls prevention exercise program among people With Parkinson's disease.
abstract: OBJECTIVE
  The aim of this study was to determine the cost-effectiveness of a 6-month minimally supervised exercise program for people with PD.
  
  
  METHODS
  An economic analysis was conducted alongside a randomized, controlled trial in which 231 people age 40 years and over with PD were randomized into a usual care control group or an exercise group. Cost-effectiveness was estimated using incremental cost per fall prevented (using falls calendars) as the primary analysis and cost per extra person avoiding mobility deterioration (defined as an improvement or no change in the 12-point Short Physical Performance Battery Score between baseline and 6 month). A cost-utility analysis using the Short Form-6D was also performed. Uncertainty was represented using cost-effectiveness scatter plots and acceptability curves. Planned subgroup analyses for the low-disease-severity group were also undertaken.
  
  
  RESULTS
  All results are reported in Australian dollars ($A). The average cost of the intervention was $A1,010 per participant. Incremental cost-effectiveness of the program relative to usual care was $A574 per fall prevented, $A9,570 per extra person avoiding mobility deterioration, and $A338,800 per quality-adjusted life year gained. The intervention had an 80% probability of being cost-effective, relative to the control, at a threshold of $A2,000 per fall prevented. Subgroup analyses for the low-disease-severity group indicate the program to be dominant, that is, less costly and more effective than usual care for all health outcomes.
  
  
  CONCLUSIONS
  The exercise intervention appeared cost-effective with regard to fall prevention in the whole sample and cost saving in the low disease severity group, when compared with usual care.
authors.affiliation: The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Inez
authors.initials: I
authors.lastname: Farag
authors.affiliation: The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Hayes
authors.affiliation: Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
authors.forename: Colleen G
authors.initials: CG
authors.lastname: Canning
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, Australia.|Prince of Wales Clinical School, University of New South Wales, Randwick, Australia.
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.affiliation: Movement Disorders Unit, Department of Neurology, Westmead Hospital, and Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Victor S C
authors.initials: VS
authors.lastname: Fung
authors.affiliation: Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Institute for Choice, University of South Australia, North Sydney, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000150:complications*
keywords: Parkinson's disease; cost-effectiveness; exercise programs; falls prevention