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Economic evaluation of a falls prevention exercise program among people With Parkinson's disease
Author(s) -
Farag Inez,
Sherrington Catherine,
Hayes Alison,
Canning Colleen G.,
Lord Stephen R.,
Close Jacqueline C.T.,
Fung Victor S.C.,
Howard Kirsten
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26420
Subject(s) - cost effectiveness , physical therapy , randomized controlled trial , medicine , cost effectiveness analysis , quality adjusted life year , cost–benefit analysis , quality of life (healthcare) , subgroup analysis , incremental cost effectiveness ratio , economic evaluation , intervention (counseling) , physical medicine and rehabilitation , confidence interval , surgery , nursing , risk analysis (engineering) , ecology , pathology , biology
Objective The aim of this study was to determine the cost‐effectiveness of a 6‐month minimally supervised exercise program for people with PD. Methods An economic analysis was conducted alongside a randomized, controlled trial in which 231 people age 40 years and over with PD were randomized into a usual care control group or an exercise group. Cost‐effectiveness was estimated using incremental cost per fall prevented (using falls calendars) as the primary analysis and cost per extra person avoiding mobility deterioration (defined as an improvement or no change in the 12‐point Short Physical Performance Battery Score between baseline and 6 month). A cost‐utility analysis using the Short Form‐6D was also performed. Uncertainty was represented using cost‐effectiveness scatter plots and acceptability curves. Planned subgroup analyses for the low‐disease‐severity group were also undertaken. Results All results are reported in Australian dollars ($A). The average cost of the intervention was $A1,010 per participant. Incremental cost‐effectiveness of the program relative to usual care was $A574 per fall prevented, $A9,570 per extra person avoiding mobility deterioration, and $A338,800 per quality‐adjusted life year gained. The intervention had an 80% probability of being cost‐effective, relative to the control, at a threshold of $A2,000 per fall prevented. Subgroup analyses for the low‐disease‐severity group indicate the program to be dominant, that is, less costly and more effective than usual care for all health outcomes. Conclusion The exercise intervention appeared cost‐effective with regard to fall prevention in the whole sample and cost saving in the low disease severity group, when compared with usual care. © 2015 International Parkinson and Movement Disorder Society