Economic Evaluation and Transferability of Physical Activity Programmes in Primary Prevention: A Systematic Review

Wolfenstetter, Silke B.; Wenig, Christina M.

doi:10.3390/ijerph7041622

Cited by 19 publications

(26 citation statements)

References 53 publications

(211 reference statements)

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“…Consistent with our findings, she also found that a very few included studies explored variability from place to place and discussed caveats regarding the generalizability of results, ‘leading to a wide variation in the transferability of the study results ranging from “low” to “very high” with everything in between’ 96. Another study 97 found that population and methodological characteristics were poorly reported—a finding that echoes our own results on the weaknesses of the models.…”

Section: Discussionsupporting

confidence: 87%

Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

et al. 2017

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AimsTo identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context.MethodsA systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist‐based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model‐based economic evaluation, that did not consider adult population and not from a high‐income country were excluded.FindingsAmong the 64 economic evaluations included in the review, the state‐transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life‐time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35–0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method.ConclusionAll existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context.

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Section: Discussionsupporting

confidence: 87%

Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

et al. 2017

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“…The reviewed modelling studies have their own limitations: the assumptions underlying the models can differ considerably, for instance, as regards the assumptions on the proportion of people becoming active as a result of the brief intervention, outcome measures and on the decay in intervention effect over time. Such methodological differences between the studies as well as other context characteristics (eg, the variability in funding mechanism, health system and cost structures) limit the generalisability of the cost-effectiveness results across different settings 68. In addition, some of the studies included in this analysis lack intervention details, for example, time duration and/or delivery method (eg, type of provider and individual vs group delivery), making it difficult to determine whether or not the interventions were truly ‘brief interventions’ according to the NICE definition.…”

Section: Discussionmentioning

confidence: 99%

“…Such methodological differences between the studies as well as other context characteristics (eg, the variability in funding mechanism, health system and cost structures) limit the generalisability of the cost-effectiveness results across different settings. 68 In addition, some of the studies included in this analysis lack intervention details, for example, time duration and/or delivery method (eg, type of provider and individual vs group delivery), making it difficult to determine whether or not the interventions were truly 'brief interventions' according to the NICE definition. It is important to describe interventions in sufficient detail, 69 such as the duration of 'brief interventions', as it affects cost-effectiveness.…”

Section: Strengths and Limitations Of The Reviewmentioning

confidence: 99%

Are brief interventions to increase physical activity cost-effective? A systematic review

et al. 2015

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ObjectiveTo determine whether brief interventions promoting physical activity are cost-effective in primary care or community settings.DesignSystematic review of economic evaluations.Methods and data sourcesWe searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit, SPORTDiscus, PEDro, the Cochrane library, National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry up to 20 August 2014. Web of Knowledge was used for cross-reference search. We included studies investigating the cost-effectiveness of brief interventions, as defined by National Institute for Health and Care Excellence, promoting physical activity in primary care or the community. Methodological quality was assessed using Drummond's checklist for economic evaluations. Data were extracted from individual studies fulfilling selection criteria using a standardised pro forma. Comparisons of cost-effectiveness and cost-utility ratios were made between studies.ResultsOf 1840 identified publications, 13 studies fulfilled the inclusion criteria describing 14 brief interventions. Studies varied widely in the methods used, such as the perspective of economic analysis, intervention effects and outcome measures. The incremental cost of moving an inactive person to an active state, estimated for eight studies, ranged from £96 to £986. The cost-utility was estimated in nine studies compared with usual care and varied from £57 to £14 002 per quality-adjusted life year; dominant to £6500 per disability-adjusted life year; and £15 873 per life years gained.ConclusionsBrief interventions promoting physical activity in primary care and the community are likely to be inexpensive compared with usual care. Given the commonly accepted thresholds, they appear to be cost-effective on the whole, although there is notable variation between studies.

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“…However, this argument may apply even less for environmental and, particularly, behavioral interventions to prevent or manage obesity than for medical interventions to manage obesity, such as pharmacotherapy or bariatric surgery. In addition to the frequently arising methodological problems limiting the generalizability and transferability of study results [49], this is primarily owing to the important role of contextual factors, of implementation factors and program integrity, which are critical in judging the findings of a study [50], and which unfortunately are rarely reported in sufficient detail. The TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) statement provides a useful guide to the reporting of contextual and process factors that need to be known in order to fully understand the outcomes of an intervention [112].…”

Section: Expert Commentarymentioning

confidence: 99%

Combating pediatric obesity in Germany: the role of economic findings in informing policy

John¹,

Teuner

2012

Expert Review of Pharmacoeconomics & Outcomes Research

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As in most countries, overweight and obesity among children and adolescents have dramatically increased in Germany over the last two decades. This serious public-health challenge has stimulated many efforts to curb the pediatric obesity epidemic. In this article, the authors briefly describe these efforts and examine the role of health economics in informing German health policies and evaluating the outcomes of interventions aimed at reducing pediatric obesity. The findings indicate that the tools of health-economic analysis have rarely been used to guide the development of strategies to prevent pediatric obesity and to support decision-making on the use of the scarce resources available for preventive actions. The authors give some reasons why health economics has not been an important policy tool so far and make some recommendations for how this could be changed. Reasons impeding health economics playing a more important role in this area are the existence of many unsolved issues in the methods of health economic evaluation and large gaps in the knowledge base on the effectiveness of interventions. Nevertheless, these methods should be considered to be indispensible tools of health policy development. However, taking into account the broad range of political and societal concerns related to pediatric obesity, decision-making in this area will ultimately rest on a process of deliberate thinking integrating different perspectives among, which health economics will be one.

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Economic Evaluation and Transferability of Physical Activity Programmes in Primary Prevention: A Systematic Review

Cited by 19 publications

References 53 publications

Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

Are brief interventions to increase physical activity cost-effective? A systematic review

Combating pediatric obesity in Germany: the role of economic findings in informing policy

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