Cost-effectiveness of a proportionate universal offer of free exercise : Leeds Let’s Get Active

Objectives To assess the cost-effectiveness of a proportionate universal programme to reduce physical inactivity (Leeds Let’s Get Active) in adults. Methods A continuous-time Markov chain model was developed to assess the cost implications and QALY gains associated with increases in physical activity levels across the adult population. An ordered logistic model was specified to estimate the effectiveness of the Leeds Let’s Get Active programme and derive transition probabilities between physical activity categories. A parametric survival analysis approach was applied to estimate the decay of intervention effect over time. Baseline model data were obtained from previous economic models, population-based surveys and other published literature. A cost-utility analysis was conducted from a health care sector perspective over the programme duration (39 months). Scenario and probabilistic sensitivity analyses were performed to test the robustness of cost-effectiveness results. Results 51,874 adult residents registered to the programme and provided baseline data, 19.5% of which were living in deprived areas. Under base case assumptions, Leeds Let’s Get Active was found to be likely to be cost-effective. However, variations in key structural assumptions showed sensitivity of the results. Conclusions Evidence from this study suggests that a universal offer of access to free off-peak leisure centre-based exercise that targets hard to reach groups can provide good value for money. Further data collection is needed to reduce the uncertainty surrounding the decision.