Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males

Objectives We sought to extrapolate the long-term costs and clinical impacts attributed to the rugby fans in training–New Zealand (RUFIT-NZ) trial in Aotearoa, New Zealand.Design A modelled cost-effectiveness analysis using efficacy data from RUFIT-NZ was conducted from the Aotearoa New Zealand heal...

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Main Authors: Kate Hunt, Yannan Jiang, Lan Gao, Ralph Maddison, Peter Lee, Stephen Kara, Cindy Gray, Helen Eyles, Nick Draper, Elaine Hargreaves, Amanda Calder, Samantha Marsh, Ihirangi Heke
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/7/e073740.full
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author Kate Hunt
Yannan Jiang
Lan Gao
Ralph Maddison
Peter Lee
Stephen Kara
Cindy Gray
Helen Eyles
Nick Draper
Elaine Hargreaves
Amanda Calder
Samantha Marsh
Ihirangi Heke
author_facet Kate Hunt
Yannan Jiang
Lan Gao
Ralph Maddison
Peter Lee
Stephen Kara
Cindy Gray
Helen Eyles
Nick Draper
Elaine Hargreaves
Amanda Calder
Samantha Marsh
Ihirangi Heke
author_sort Kate Hunt
collection DOAJ
description Objectives We sought to extrapolate the long-term costs and clinical impacts attributed to the rugby fans in training–New Zealand (RUFIT-NZ) trial in Aotearoa, New Zealand.Design A modelled cost-effectiveness analysis using efficacy data from RUFIT-NZ was conducted from the Aotearoa New Zealand healthcare perspective.Setting A Markov cohort model was constructed with a lifetime time horizon. The model simulated events of myocardial infarction (MI), stroke and type 2 diabetes mellitus (T2DM) occurring among a hypothetical cohort of 10 000 individuals receiving either the RUFIT-NZ intervention or no intervention. Efficacy data were based on the RUFIT-NZ trial, and the latest Global Burden of Disease study was used to extrapolate the impact of body weight reduction on clinical outcomes of T2DM, MI or stroke. Cost and utility data were drawn from the RUFIT-NZ trial and published sources.Primary outcome measures The incremental cost-effectiveness ratio (ICER).Results Over a lifetime time horizon, participants in the RUFIT-NZ intervention gained 0.02 (discounted) quality-adjusted life years (QALYs) at an additional cost of NZ$863, relative to no intervention. The estimated ICER was NZ$49 515 per QALY gained (discounted), which is above the arbitrary willingness-to-pay threshold of NZ$45 000 per QALY. Sensitivity analyses supported the robustness of these findings.Conclusions RUFIT-NZ was associated with a reduction in cardiovascular and endocrine events for overweight and obese males. However, based on conservative assumptions, RUFIT-NZ was unlikely to be cost-effective from a healthcare system perspective.Trial registration number ACTRN12619000069156.
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spelling doaj-art-770a5d582d654cbf9b7bc3edba49acd72025-08-20T02:43:19ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2023-073740Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for malesKate Hunt0Yannan Jiang1Lan Gao2Ralph Maddison3Peter Lee4Stephen Kara5Cindy Gray6Helen Eyles7Nick Draper8Elaine Hargreaves9Amanda Calder10Samantha Marsh11Ihirangi Heke126 Institute for Social Marketing, University of Stirling, Stirling, UK2 Department of Statisitics, University of Auckland, Auckland, New Zealand1 Deakin Health Economics, Institute for Health Transformation, Deakin University, Burwood Hwy, Burwood, Victoria, AustraliaInstitute for Physical Activity and Nutrition, Deakin University, Melbourne, UK2 School of Health and Social Development, Deakin University, Burwood, Victoria, Australia9 Axis Sport Medicine Clinic, Auckland, New ZealandSchool of Social and Political Sciences, University of Glasgow, Glasgow, UK4 National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand2 Sport, Health and Rehabilitation Research Centre, Faculty of Health, University of Canterbury, Christchurch, New Zealand2 School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand4 National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand4 National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand8 Heke Consulting, Auckland, New ZealandObjectives We sought to extrapolate the long-term costs and clinical impacts attributed to the rugby fans in training–New Zealand (RUFIT-NZ) trial in Aotearoa, New Zealand.Design A modelled cost-effectiveness analysis using efficacy data from RUFIT-NZ was conducted from the Aotearoa New Zealand healthcare perspective.Setting A Markov cohort model was constructed with a lifetime time horizon. The model simulated events of myocardial infarction (MI), stroke and type 2 diabetes mellitus (T2DM) occurring among a hypothetical cohort of 10 000 individuals receiving either the RUFIT-NZ intervention or no intervention. Efficacy data were based on the RUFIT-NZ trial, and the latest Global Burden of Disease study was used to extrapolate the impact of body weight reduction on clinical outcomes of T2DM, MI or stroke. Cost and utility data were drawn from the RUFIT-NZ trial and published sources.Primary outcome measures The incremental cost-effectiveness ratio (ICER).Results Over a lifetime time horizon, participants in the RUFIT-NZ intervention gained 0.02 (discounted) quality-adjusted life years (QALYs) at an additional cost of NZ$863, relative to no intervention. The estimated ICER was NZ$49 515 per QALY gained (discounted), which is above the arbitrary willingness-to-pay threshold of NZ$45 000 per QALY. Sensitivity analyses supported the robustness of these findings.Conclusions RUFIT-NZ was associated with a reduction in cardiovascular and endocrine events for overweight and obese males. However, based on conservative assumptions, RUFIT-NZ was unlikely to be cost-effective from a healthcare system perspective.Trial registration number ACTRN12619000069156.https://bmjopen.bmj.com/content/14/7/e073740.full
spellingShingle Kate Hunt
Yannan Jiang
Lan Gao
Ralph Maddison
Peter Lee
Stephen Kara
Cindy Gray
Helen Eyles
Nick Draper
Elaine Hargreaves
Amanda Calder
Samantha Marsh
Ihirangi Heke
Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
BMJ Open
title Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
title_full Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
title_fullStr Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
title_full_unstemmed Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
title_short Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males
title_sort long term cost effectiveness analysis of rugby fans in training new zealand a body weight reduction programme for males
url https://bmjopen.bmj.com/content/14/7/e073740.full
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