Objective: To develop a model to assess the long-term costs and health outcomes of physical activity interventions targeting adolescents.
Design: A Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken.
Setting: School and community.
Participants: A hypothetical cohort of adolescents aged 16 years at baseline.
Interventions: Two exemplar school-based: a comparatively simple, after-school intervention and a more complex multicomponent intervention compared with usual care.
Primary and secondary outcome measures: Incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained.
Results: The model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time.
Conclusions: The model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
Keywords: cost-effectiveness; health economics; physical activity; young adult.
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.