Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study.

Camila Bosquiero Papini,Priscila Missaki Nakamura,Bruna Thaís Gomes De Brito,Leonardo De Campos,Eduardo Kokubun

doi:10.1590/1413-812320212611.27142020

Abstract

Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

Highlights

Noncommunicable Diseases (NCDs) are responsible for approximately 72% of deaths in Brazil
A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG)
The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons

Summary

Introduction

Noncommunicable Diseases (NCDs) are responsible for approximately 72% of deaths in Brazil. Around 45% of the Brazilian population reports at least one NCDs; the incidence of diabetes and hypertension has increased 61% and 14%, respectively, over the last 10 years and their main risk factors are smoking, harmful use of alcohol, unhealthy diets and physical inactivity[1,2,3,4]. NCDs demand decades of health services use and represent a significant burden over health care costs, which corresponds to a direct cost of more than R$ 7 billion per year in Brazil[5,6,7]. The elimination of physical inactivity is estimated to remove from 6% to 10% of the main NCDs9. Investment in public policies is fundamental to increase the population physical activity levels and reduce the NCDs prevalence

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Discussion

Conclusion