Background: Counseling in combination with pedometer use has proven to be effective in increasing physical activity and improving health outcomes. We investigated the cost-effectiveness of this intervention targeted at one million insufficiently active adults who visit their general practitioner in the Netherlands.Methods: We used the RIVM chronic disease model to estimate the long-term effects of increased physical activity on the future health care costs and quality adjusted life years (QALY) gained, from a health care perspective.Results: The intervention resulted in almost 6000 people shifting to more favorable physical-activity levels, and in 5100 life years and 6100 QALYs gained, at an additional total cost of EUR 67.6 million. The incremental cost-effectiveness ratio (ICER) was EUR 13,200 per life year gained and EUR 11,100 per QALY gained. The intervention has a probability of 0.66 to be cost-effective if a QALY gained is valued at the Dutch informal threshold for cost-effectiveness of preventive intervention of EUR 20,000. A sensitivity analysis showed substantial uncertainty of ICER values.Conclusion: Counseling in combination with pedometer use aiming to increase physical activity may be a cost-effective intervention. However, the intervention only yields relatively small health benefits in the Netherlands.

Counseling, Economic evaluation, Modeling, Pedometer use, Physical activity, Prevention, Primary care
dx.doi.org/10.1186/1478-7547-10-13, hdl.handle.net/1765/38680
Cost Effectiveness and Resource Allocation
Erasmus MC: University Medical Center Rotterdam

Over, E.A.B, Wendel-Vos, G.C.W, van den Berg, M, Reenen, H.H.H, Tariq, L, Hoogenveen, R.T, & van Baal, P.H.M. (2012). Cost-effectiveness of counseling and pedometer use to increase physical activity in the Netherlands: a modeling study. Cost Effectiveness and Resource Allocation, 10, 1–7. doi:10.1186/1478-7547-10-13