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Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment
  1. Emma J Frew1,
  2. Mobeen Bhatti2,
  3. Khine Win3,
  4. Alice Sitch4,
  5. Anna Lyon5,
  6. Miranda Pallan5,
  7. Peymane Adab5
  1. 1Health Economics Unit, Public Health Building, University of Birmingham, Birmingham, UK
  2. 2NHS Heart of Birmingham Teaching Primary Care Trust, Birmingham, UK
  3. 3NHS Birmingham East & North Primary Care Trust, Birmingham, UK
  4. 4Department of Statistics, Public Health Building, University of Birmingham, Birmingham, UK
  5. 5Public Health Department, Public Health Building, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Emma J Frew, Health Economics Unit, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;e.frew{at}


Objective To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK.

Methods Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using ‘willingness-to-pay’ as a measure of value.

Results Under base-case assumptions—that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society.

Conclusions Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.

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