Cost-effectiveness of a Physical Activity

Awareness Campaign

Jennie Petersen, MSc. StudentDept. of Community Health Sciences

Faculty of MedicineUniversity of Calgary

VERB Awareness Campaign

VERB - Physical Activity Awareness Campaign Target: Children 9-13 years old

National-level campaign implemented in 2002 in the USA

Two-year evaluation in 2004 (Huhman et al., 2007)

Purpose: Examine effect of VERB on children’s behaviour

Study design: Longitudinal cohort, n=2257

Measurement tool: Youth Media Campaign Longitudinal Survey

Result: Significant dose-response relationship between ‘aware’ and ‘unaware’ children

Research Questions

1) What is the cost-effectiveness (CE) of the VERB physical activity (PA) awareness campaign?

2) What are the implications of the results for Canada?

Methods Evidence from the VERB campaign was used to

determine the CE of a PA campaign

Extrapolated results to 60 years of age and estimated: Cases of CVD prevented Net medical costs (cost-offsets)

Cost-Effectiveness Analysis (Modeling) Compared PA campaign with ‘Do Nothing’ strategy Adopted a health care payer perspective Estimated (net) cost per case of CVD prevented

Model

Model

81%

61%

29%

17%

Variable Base Case (95%CI) Data Source

Campaign Awareness 0.81

VERB Study (Huhman et al., 2007)

Probability of being Active if Aware 0.612 (0.583-0.640)

Probability of being Active if Unaware 0.457 (0.389-0.525)

Cost of Campaign / # Children $194 M / 21 M children (US$)

Average age of participants (end of campaign)

13 years (11-15)

Probability of Active Child becoming Active Adult

0.2925 (0.14-0.44) Telama et al., 2005

Probability of CVD if Active 0.1668

Wang et al., 2004

Probability of CVD if Sedentary 0.2363

Medical cost of CVD if Active $3784 (US$)

Medical cost of CVD if Sedentary $6313 (US$)

Medical cost of No CVD if Active $1476 (US$)

Medical cost of No CVD if Sedentary $1590 (US$)

Avg. age of onset of CVD 59.8 years (51.4-68.2) Weaver, et al., 1997

Results Cost of the VERB campaign

(US) $9,240 per 1000 children

Cases of no CVD PA Campaign: 775.5 cases per 1000 children Do Nothing Strategy: 772.9 cases per 1000 children Difference: 2.6 per 1000 children

Lifetime medical costs PA Campaign: (US) $33,414,000 per 1000 children Do Nothing Strategy: (US) $33,495,000 per 1000 children Difference: (US) -$81,000 per 1000 children

Net costs of the intervention (US) -$71,760 per 1000 children … cost savings!

Sensitivity / Scenario Analysis Result remains robust to changes in:

Awareness levels Probability of an active child becoming an active adult Prevalence of CVD in active and inactive people Campaign effectiveness

Result was not robust to changes in: Medical Costs

Assumptions … limitations

Difference in PA attributed solely to the campaign

Sedentary children remain sedentary as adults

PA behaviour doesn’t change over lifetime, except from adolescence into adulthood

Excluded health care costs associated with PA

Only included benefits of PA in preventing CVD

Conclusions VERB PA Campaign aimed at children appears

highly cost-effective

Strength of this CE is limited by strength of evidence / assumptions used in the model

Results remain robust to changes in most assumptions … but not all

Relied on US data! … Implications for Canada?

Acknowledgements

Collaborators: Dr. Alan Shiell Dr. Tish Doyle-Baker Ms. Michelle Fry

Special Thanks: Dr. Herb Emery Dr. Fiona Shrive Dr. Braden Manns

Funding: Canadian Institutes of Health Research