Cost-effectiveness of pedometer-based versus time-based Green Prescriptions: the Healthy Steps Study
William Leung A D , Toni Ashton A , Gregory S. Kolt B C , Grant M. Schofield C , Nicholas Garrett C , Ngaire Kerse A and Asmita Patel CA School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
B School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
C Centre for Physical Activity and Nutrition, Auckland University of Technology, AUT North Shore Campus, Mail # A24, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
D Corresponding author. Email: w.leung@auckland.ac.nz
Australian Journal of Primary Health 18(3) 204-211 https://doi.org/10.1071/PY11028
Submitted: 8 March 2011 Accepted: 11 August 2011 Published: 5 March 2012
Abstract
This paper reports on the cost-effectiveness of pedometer-based versus time-based Green Prescriptions in improving physical activity and health-related quality of life (EQ-5D) in a randomised controlled trial of 330 low-active, community-based adults aged 65 years and over. Costs, measured in $NZ (NZ$1 = A$0.83, December 2008), comprised public and private health care costs plus exercise-related personal expenditure. Based on intention-to-treat data at 12-month follow up, the pedometer group showed a greater increase in weekly leisure walking (50.6 versus 28.1 min for the time-based group, adjusted means, P = 0.03). There were no significant between-group differences in costs. The incremental cost-effectiveness ratios, for the pedometer-based versus time-based Green Prescription, per 30 min of weekly leisure walking and per quality-adjusted life year were, (i) when including only community care costs, $115 and $3105, (ii) when including only exercise and community care costs, $130 and $3500, and (iii) for all costs, −$185 and −$4999, respectively. The cost-effectiveness acceptability curves showed that the pedometer-based compared with the time-based Green Prescription was statistically cost-effective, for the above cost categories, at the following quality-adjusted life year thresholds: (i) $30 000; (ii) $30 500; and (iii) $16 500. The additional program cost of converting one sedentary adult to an active state over a 12-month period was $667. The outcomes suggest the pedometer-based Green Prescription may be cost-effective in increasing physical activity and health-related quality of life over 12 months in previously low-active older adults.
Additional keywords: economic evaluation, older adults, physical activity.
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