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Randomized Controlled Trial
. 2025 Jan 15;25(1):160.
doi: 10.1186/s12889-024-21103-6.

Cost-utility and cost-benefit analysis of a multi-component intervention (NEXpro) for neck-related symptoms in Swiss office workers

Beatrice Brunner  1 , Andrea Martina Aegerter  2 , Venerina Johnston  3   4 , Thomas Volken  5 , Manja Deforth  5   6 , Gisela Sjøgaard  7 , Achim Elfering  8 , Markus Melloh  5   9 ; NEXpro Collaboration Group
Collaborators, Affiliations
Randomized Controlled Trial

Cost-utility and cost-benefit analysis of a multi-component intervention (NEXpro) for neck-related symptoms in Swiss office workers

Beatrice Brunner et al. BMC Public Health. .

Abstract

Background: Neck pain is a significant public health issue, especially among office workers, with a prevalence ranging from 42 to 68%. This study aimed to evaluate the cost-utility and cost-benefit of a multi-component intervention targeting neck pain in the general population of office workers in Switzerland. The 12-week multi-component intervention consisted of neck exercises, health promotion information workshops, and workplace ergonomics sessions.

Methods: The study was designed as a stepped-wedge cluster randomized controlled trial and assessed using an employer's perspective. The main analysis focused on the immediate post-intervention period. Long-term effects were examined in a subsample at the 4, 8, and 12-month follow-ups. The intervention effects on costs and quality-adjusted life years (QALYs) were estimated using generalized linear mixed-effects models, controlling for confounding factors. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves were presented, along with calculations of the break-even point and the return on investment. Various sensitivity analyses were performed.

Results: A total of 120 office workers participated in the trial, with 100 completing the intervention period and 94 completing the entire study. The main analysis included 392 observations. The intervention had a significant positive effect on QALYs and a nonsignificant effect on costs. The ICER was estimated at -25,325 per QALY gain, and the probability of the intervention being cost saving was estimated at 88%. The break-even point was reached one week after the end of the intervention.

Conclusion: The multi-component intervention is likely to reduce company costs and simultaneously improve the quality of life of employees. However, the implementation of such interventions critically depends on evidence of their cost-effectiveness. As there is still a large research gap in this area, future studies are needed.

Trial registration: ClinicalTrials.gov, NCT04169646 . Registered 15 November 2019-Retrospectively registered.

Trial protocol: Aegerter AM, Deforth M, Johnston V, Ernst MJ, Volken T, Luomajoki H, et al. On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial. BMC Musculoskelet Disord. 2020;21(1):391. https://doi.org/10.1186/s12891-020-03388-x .

Keywords: Cost-utility; Health economic evaluation; Neck pain; Presenteeism; Quality adjusted life years; Randomized controlled trial; Workplace intervention.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all individual participants included in the study. Approval was granted by the Ethics Committee of the Canton of Zurich, Switzerland (15.10.2019, swissethics no. 2019–01678). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PPersistence of effects after the end of the intervention. Panel A shows the change in QALYs at 0, 4, 8, and 12 months after the end of the intervention. Panel B shows the change in costs at 0, 4, 8, and 12 months after the end of the intervention. Key: N = 392, 357, 327, 326 at post-intervention month 0, 4, 8 and 12. The points represent the average marginal effects of the intervention at different post intervention follow-up time periods, the bars represent the 95% confidence intervals
Fig. 2
Fig. 2
CEP and CEAC. Panel A shows the cost-effectiveness plane (CEP) with the point estimate representing the average marginal effect on QALYs and costs (= ICER). Uncertainty is represented by the confidence ellipses. Panel B shows the corresponding cost-effectiveness acceptability curve (CEAC) Key: N = 392
See this image and copyright information in PMC

References

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