The cost-effectiveness of the SMART work & life intervention for reducing sitting time

Cox, E; Walker, S; Edwardson, CL; Biddle, SJH; Clarke-Cornwell, AM; Clemes, SA; Davies, MJ; Dunstan, DW; Eborall, H; Granat, MH; Gray, LJ; Healy, GN; Maylor, BD; Munir, F; Yates, T; Richardson, G

Abstract

Sedentary behaviours continue to increase and are associated with heightened risks of morbidity and mortality. We assessed the cost-effectiveness of SMART Work & Life (SWAL), an intervention designed to reduce sitting time inside and outside of work, both with (SWAL-desk) and without (SWAL-only) a height-adjustable workstation compared to usual practice (control) for UK office workers. Health outcomes were assessed in quality-adjusted life-years (QALY) and costs in pound sterling (2019–2020). Discounted costs and QALYs were estimated using regression methods with multiply imputed data from the SMART Work & Life trial. Absenteeism, productivity and wellbeing measures were also evaluated. The average cost of SWAL-desk was £228.31 and SWAL-only £80.59 per office worker. Within the trial, SWAL-only was more effective and costly compared to control (incremental cost-effectiveness ratio (ICER): £12,091 per QALY) while SWAL-desk was dominated (least effective and most costly). However, over a lifetime horizon, both SWAL-only and SWAL-desk were more effective and more costly than control. Comparing SWAL-only to control generated an ICER of £4985 per QALY. SWAL-desk was more effective and costly than SWAL-only, generating an ICER of £13,378 per QALY. Findings were sensitive to various worker, intervention, and extrapolation-related factors. Based on a lifetime horizon, SWAL interventions appear cost-effective for office-workers conditional on worker characteristics, intervention cost and longer-term maintenance in sitting time reductions.

Citation

Cox, E., Walker, S., Edwardson, C., Biddle, S., Clarke-Cornwell, A., Clemes, S., …Richardson, G. (2022). The cost-effectiveness of the SMART work & life intervention for reducing sitting time. International Journal of Environmental Research and Public Health, 18(22), 14861. https://doi.org/10.3390/ijerph192214861

• Journal Article Type: Article
• Acceptance Date: Nov 9, 2022
• Publication Date: Nov 11, 2022
• Deposit Date: Nov 14, 2022
• Publicly Available Date: Nov 14, 2022
• Journal: International Journal of Environmental Research and Public Health
• Publisher: MDPI
• Volume: 18
• Issue: 22
• Pages: 14861
• DOI: https://doi.org/10.3390/ijerph192214861
• Publisher URL: https://doi.org/10.3390/ijerph192214861
• Additional Information: Projects : The effectiveness of the SMArT Work & Life intervention for reducing sitting time in office workers