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. 2022 Nov 11;19(22):14861.
doi: 10.3390/ijerph192214861.

The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time

Edward Cox  1 , Simon Walker  1 , Charlotte L Edwardson  2   3 , Stuart J H Biddle  4 , Alexandra M Clarke-Cornwell  5 , Stacy A Clemes  3   6 , Melanie J Davies  2   3   7 , David W Dunstan  8   9 , Helen Eborall  10   11 , Malcolm H Granat  5 , Laura J Gray  10 , Genevieve N Healy  12 , Benjamin D Maylor  2 , Fehmidah Munir  6 , Thomas Yates  2   3 , Gerry Richardson  1
Affiliations

The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time

Edward Cox et al. Int J Environ Res Public Health. .

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.

Keywords: SMART; cost-effectiveness; healthy habits; sedentary behaviour; standing desks.

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Conflict of interest statement

The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Figures

Figure 1
Figure 1
Sensitivity analyses: (a) Incremental net health benefits for alternative treatment decay profiles at a cost-effectiveness threshold of £15,000 per QALY; (b) Incremental net health benefits for alternative age profiles at a cost-effectiveness threshold of £15,000 per QALY.
See this image and copyright information in PMC

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