Cost-Effectiveness of a Cardiac Rehabilitation Program Specifically Designed for Patients With Obesity Within the OPTICARE XL Randomized Controlled Trial

L.A. Visser (Corresponding author), I. den Uijl (Corresponding author), W. K. Redekop, M. Sunamura, M. Lenzen, E. Boersma, R. W.M. Brouwers, H. M.C. Kemps, H.J.G. van den Berg-Emons, Nienke D. ter Hoeve

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Abstract

Objective: To assess the cost-effectiveness of a cardiac rehabilitation (CR) program specifically designed for cardiac patients with obesity vs standard CR. Design: Cost-effectiveness analysis based on observations in a randomized controlled trial. Setting: Three regional CR centers in the Netherlands. Participants: Cardiac patients (N=201) with obesity (BMI≥30 kg/m2) referred to CR. Interventions: Participants were randomized to a CR program specifically designed for patients with obesity (OPTICARE XL; N=102) or standard CR. OPTICARE XL included aerobic and strength exercise and behavioral coaching on diet and physical activity during 12 weeks, followed by a 9-month after-care program with “booster” educational sessions. Standard CR consisted of a 6- to 12-week aerobic exercise program, supplemented with cardiovascular lifestyle education. Main Outcome Measures: An economic evaluation, with an 18-month time horizon, in terms of quality-adjusted life years (QALYs) and costs from the societal perspective was performed. Costs were reported in 2020 Euros, discounted at a 4% annual rate, and health effects were discounted at a 1.5% annual rate. Results: OPTICARE XL CR and standard CR resulted in comparable health gain per patient (0.958 vs 0.965 QALYs, respectively; P=.96). Overall, OPTICARE XL CR saved costs (-€4542) compared with the standard CR group. The direct costs for OPTICARE XL CR were higher than for standard CR (€10,712 vs €9951), whereas indirect costs were lower (€51,789 vs €57,092), but these differences were not significant. Conclusions: This economic evaluation showed no differences between OPTICARE XL CR and standard CR in health effects and costs in cardiac patients with obesity.

Original languageEnglish
Pages (from-to)855-862
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume104
Issue number6
DOIs
Publication statusPublished - Jun 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors

Funding

This research was funded by the Dutch Organisation for Health Research and Development (ZonMw, Grant number 843001792 ) and Capri Cardiac Rehabilitation.

Keywords

  • Cardiac rehabilitation
  • Cost-effectiveness analysis
  • Obesity
  • Rehabilitation

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