PNS74 COST-EFFECTIVENESS AND RETURN-ON-INVESTMENT OF THE DYNAMIC WORK INTERVENTION

Abstract

Sedentary behaviour is associated with morbidity, mortality and high costs. The Dynamic Work intervention aimed to reduce sedentary behaviour in an occupational setting. We assessed the cost-effectiveness from a societal perspective and return-on-investment from an employers’ perspective of the Dynamic Work intervention compared to usual practice. 244 workers from a Dutch company were allocated at the department level to the intervention or usual practice (flexible workplaces, prompts to use stairs, walking footsteps routes, bags for lunch walk). In addition to usual practice, the intervention contained organizational (face–to-face session with department manager), work environmental (sit-stand desks and cycling workstations), and individual elements (counselling and activity/sitting tracker). Objectively assessed overall sitting time, standing time and step counts, and quality-adjusted life-years (QALYs) were measured at baseline, post-program and 12-month follow-up, while societal costs (healthcare utilization, informal care and lost productivity costs) were measured at post-program and long-term. Differences in costs and effects were estimated using seemingly unrelated regression. Joint uncertainty around costs and effects was estimated using bootstrapping techniques and presented in cost-effectiveness acceptability curves. No significant differences in effects and societal costs (mean difference €-994; 95% CI, -2487;-160) were observed between groups. Presenteeism costs were significantly lower in the intervention group (mean difference €-703, 95% CI, -1361;-264). The probability of the intervention being cost-effective was 0.90 at willingness-to-pay thresholds of 20000 €/QALY. The net benefit was €637/worker (95% CI, -394; 1770). Per euro invested, €3 (95% CI, 0; 7) was returned. The percentage of profit would be 224% (95% CI, -139; 622). The probability that implementation of the intervention results in financial savings to the employer was 0.86. The intervention is likely to be cost-beneficial from both a societal and employer’s perspective as a result of lower costs related to presenteeism in the intervention group.