Table 3

Characteristics of included studies

Study, setting, qualityObjective; economic perspective, cost yearStudy type; economic analysis typeInterventions comparedParticipantsFollow-up durationDefinition of physically active personMean time to deliver intervention per personOutcome
Cost of converting to an ‘active category’ (£ at the time of the study) (£ inflated to 2011)ICER (£ at the time of the study) (£ inflated to 2011)
Anokye et al,35 UK, goodBrief exercise advice in primary care; healthcare (NHS), 2010/2011Economic modelling; CUAI: brief advice
C: usual care (no active intervention)
Cohort of 100 000 physically inactive but healthy adults aged ≥33 yearsModelled for lifetime150 min of MPA or 75 min of VPA per weekNot mentioned£136 (brief advice compared with usual care)£1730/QALY gained
Boehler et al,36 UK, fairPA promotion in primary care; health service (NHS), 2007PA care pathway pilot-based regression model; CEABrief exercise comparing 2 recruitment strategies:
I1: patients recruited opportunistically
I2: patients on the hypertension disease register ‘disease register sites’
Insufficiently active, 16–74 years3 months150 min of MPA per weekI1: 4 min
I2: 18 min
Total across intervention:
I1: 28 min
I2: 76 min
£886.50 (£986) disease register vs opportunistic recruitment
Cobiac et al,44 Australia, highPA promotion in community; health sector, 2003Economic modelling study; CUAI1: GP prescription—exercise prescription with follow-up phone call
I2: GP referral for PA counselling to an exercise physiologist
I3: mass media
I4: TravelSmart (active transport)
I5: pedometer
I6: internet advice
C: do nothing
I1: 40–79 years old less active patients
I2: 60+ years sedentary
I3: 25–60 years
14: 18+ years
I5: 15+ years
I6: 15+ years
Modelled for lifetime150 min of moderate intensity of 5 METs per weekNot mentionedI1: $A11 000 (£5374) (£6500) per DALY
I2: $A75 000 (£36 638) (£44 315 ) per DALY
I3: dominant
I4: $A 18 000 (£8793) (£10 636 ) per DALY
I5: dominant
I6: $A2000 (£977) (£1182) per DALY when compared with ‘do nothing’
Dalziel et al,40 New Zealand, highPrimary care-based exercise counselling/prescription; health system, 2001RCT-based economic modelling; CUAI: green prescription
C: usual care (no additional exercise advice)
Less active participants; 40–79 years
I: 451
C: 427
Modelled over full life expectancy5×30 min of MPA or VPA per week7 min (GP); 13 min (practice nurse)NZD 2053 (£865) (£1104) per QALY (lifetime)
Elley et al,42 New Zealand, highPrimary care exercise counselling/prescription; health funder's and societal, 2001RCT; CEAI: green prescription (brief oral or written advice) by a GP or practice nurse with telephone exercise specialist follow-up
C: usual care (do nothing)
40–79 years old less active patients in general practice
I: 451
C: 427
12 months150 min/week7 min (GP); 13 min (nurse)NZD 1756 (£740) (£938)
Elley et al,41 New Zealand, highPrimary care exercise counselling/prescription with ongoing support; Societal, 2008RCT; CEAI: enhanced green prescription (nurse-delivered brief advice and a written exercise prescription, counselling in primary care with telephone follow-up)
C: usual care (do nothing)
Physically inactive women aged 40–74 years
I: 544
C: 545
24 months150 min/week of at least MPA10 min brief advice and a written prescriptionNZD 687 (£285) (£308) sustained at 12 months; NZD 1407 (£584) (£630) sustained at 24 months
Gulliford et al,37 UK, goodUniversal strategy to promote PA in primary care; healthcare service, 2010Economic modelling; CUAI: brief GP advice in primary care
C: standard care (do nothing)
262 704 healthy participants aged 30–100 years from GPRDModelled for lifetime150 min of moderate PA per weekNot mentionedNet health benefit of 3.2 QALYs per 1000 participants (at a threshold of £30 000/QALY); £13 686 (£14 002)/QALY
Leung et al,43 New Zealand, HighPedometer-based exercise advice to increase PA; societal, 2008RCT; CUAI1: pedometer-based green prescription
I2: standard green prescription (exercise advice & time-related goal)
Healthy inactive adults aged ≥65 years
I1: 165
I2: 165
12 months150 min of at least MPA per weekNot mentioned$A667 (£290) (£313)
Lindgren et al,46 Sweden, goodDietary and exercise advice; societal and payer's, 2000RCT-based economic modelling; CEAI1: dietary advice by dieticians
I2: exercise advice by a physician
I3: exercise & diet
C: usual care (no intervention)
Men aged 35–60 years
I1: 40
I2: 39
I3: 39
C: 39
Modelled for lifetimeRegular PA of an aerobic type 2–3 times/week lasting 30–45 minNot mentioned but included 3 visits to a physicianSEK 180 470 (£12 263) (£15 873) per LYG for exercise compared to no intervention
Over et al,47 Netherlands, goodGP counselling in addition to pedometers to increase PA; healthcare, 2009Economic modelling; CUATwo scenarios
S1: pedometer use with diary and GP counselling
S2: current practice (no additional advice)
Insufficiently active 20–65 yearsModelled for lifetime150 min of MPA per weekNot mentioned but included 10 min GP counselling€11 100 (£8401) (£8858) per QALY
Pringle et al,38 UK, fairCommunity-based interventions to increase MPA; NHS, 2003Alongside single clinical and cost study; CEA, CUASeven intervention categories: campaigns, exercise classes, exercise referral, motivational interviews, outdoor activity, peer-mentoring, training of PA leadersInactive; 343 young people and 641 adults, particularly those aged 65 years and overModelled for lifetime using the Matrix model16150 min of MPA per weekNot mentioned£260-£1253 (£318-£1531) per completer improving MPA£47-£229 (£57-£280) per QALY
Shaw et al,39 Scotland, fairPedometer-based walking; health services, 2008RCT; CEAI: minimal intervention (walking programme and pedometer)
I2: maximal intervention (PA consultation, pedometer and individualised walking programme)
C: ‘usual behaviour’
18–65 years olds
I1: 40
I2: 39
12 monthsWeekly increase of ≥15 000 steps30 min£92 (£99) (minimal vs control)
£591 (£637) (maximal vs minimal)
Sims et al,45 Australia, fairActive script in general practice; health service, 1996Economic modelling; CEA, CUAI: ASP—improving systematic PA advice by GPs
C: routine GP care (no PA advice)
Less active adults aged 20–75 years, 670 GP advising sedentary patients
I: 40 258
C: 10 437
Unclear time horizon150 min of MPA per week4 min GP consultation$A138 (£70) (£96) per patient to become active$A3647 (£1838) (£2542) per DALY saved
  • ASP, Active Script Programme; CEA, cost-effectiveness analysis; CUA, cost-utility analysis; DALY, disability adjusted life year; GP, general practitioner; GPRD, general practice research database; ICER, incremental cost-effectiveness ratio; LYG, life years gained; METs, metabolic equivalents; MPA, moderate-intensity physical activity; NHS, National Health Service (England); NZD, New Zealand Dollar; PA, physical activity; QALY, quality-adjusted life year; RCT, randomised controlled trial; SEK, Swedish krona; VPA, vigorous-intensity physical activity.