Abstract
Objectives
Interventions aimed at reducing falls and physical inactivity could alleviate the
economic burden attributable to these factors. The study aimed to analyze the cost-effectiveness
of a group-delivered version of the Lifestyle-integrated Functional Exercise Program
compared with an individually delivered program version.
Design
An economic evaluation conducted alongside the LiFE-is-LiFE randomized non-inferiority
trial.
Interventions
Group and individually delivered version of a program consisting of strength and balance
exercises integrated into everyday activities to prevent falls.
Setting and participants
309 community-dwelling older adults (aged ≥70 years) at risk of falling recruited
around Heidelberg and Stuttgart (Germany).
Methods
Cost-effectiveness of the group program was assessed over 6 months using different
effect measures [quality-adjusted life years (QALYs, EQ-5D-5L), physical activity
(mean number of steps/day), and falls] and cost perspectives (societal and payer’s).
Incremental cost-effectiveness ratios were determined, and cost-effectiveness acceptability
curves were constructed.
Results
From a societal perspective, mean costs, the number of falls, and the number of steps/day
were somewhat higher in the group program, whereas QALYs were almost identical between
the 2 interventions. From the payer’s perspective, the incremental cost-effectiveness
ratio for the group compared to the individual program were €56,733 per QALY and €4755
per fall prevented. Based on the cost-effectiveness acceptability curves, the cost-effectiveness
of the group program had to be rated as uncertain for both effect measures and perspectives.
In contrast, it demonstrated cost-effectiveness for increasing physical activity at
willingness-to-pay values per additional 1000 steps/day of €1600 (societal perspective)
or €600 (payer’s perspective).
Conclusions and Implications
Compared to the individual program, the group program might be cost-effective for
increasing physical activity in older adults but was unlikely to be cost-effective
with regard to QALY or for preventing falls. The cost-effectiveness should be evaluated
long-term and compared to a regular care group.
Keywords
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Article info
Publication history
Published online: October 06, 2021
Footnotes
This work was supported by the German Federal Ministry of Education and Research, Germany (grant: 01GL1705A-D). The funding source takes no part in the collection, analysis, and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.
The authors declare no conflicts of interest.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
