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Randomized Controlled Trial
. 2025 Jul 1;16(1):5592.
doi: 10.1038/s41467-025-59909-6.

Cost-effectiveness of the ReDIRECT/counterweight-plus weight management programme to alleviate symptoms of long COVID

Heather L Fraser  1 , Laura Haag  2 , Naomi Brosnahan  2   3 , Alex McConnachie  4 , Janice Richardson  5 , Caroline E Haig  4 , Tracy Ibbotson  6 , Jane Ormerod  7 , Catherine A O'Donnell  6 , Michael E J Lean  2 , Naveed Sattar  5 , David N Blane  6 , Emilie Combet  2 , Emma McIntosh  8
Affiliations
Randomized Controlled Trial

Cost-effectiveness of the ReDIRECT/counterweight-plus weight management programme to alleviate symptoms of long COVID

Heather L Fraser et al. Nat Commun. .

Abstract

Long-term effects of COVID-19 infection, termed Long COVID (LC), are associated with reduced quality of life. Symptoms associated with overweight/obesity overlap with and may aggravate those of LC. This paper reports the economic evaluation alongside the ReDIRECT Trial, which evaluated the impact of an evidence-based, remotely-delivered weight management programme on self-reported symptoms of LC in those living with overweight/obesity in the United Kingdom. Recruited participants (n = 234) were randomly allocated to the intervention group (weight management) or control group (usual care). Incremental costs and Quality-Adjusted Life Years (QALYs) were calculated using intervention cost, healthcare resource use and EQ-5D-5L data collected at baseline, three and 6 months. In this work, we show that the ReDIRECT intervention is likely cost-effective in improving LC symptoms from an NHS/PSS perspective, compared to usual care (Incremental Cost-Effectiveness Ratio of £14,754/QALY). Adopting a broader societal perspective, the intervention becomes potentially cost saving compared to usual care.

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Conflict of interest statement

Competing interests: N.B. is an employee and shareholder of Counterweight Ltd., subcontracted to the University of Glasgow to deliver the ReDIRECT intervention. A.M. is a member of Clinical Steering Committee for ARC Medical Inc. N.S. has received institutional grant support from AstraZeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics and honoraria from Abbott Laboratories, AbbVie, Afimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Janssen, Menarini-Ricerche, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Roche Diagnostics, Sanofi. M.L. has received lecturing fees from Novo Nordisk, Lilly, Nestle, Oviva, Merck, and Sanofi and is a medical advisor to Counterweight Ltd, with fees paid to the University of Glasgow. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Utility score from EQ5D questionnaire by trial arm at baseline, 3 months, and 6 months after randomisation.
a Line graph showing mean utility score by trial arm, with standard error shading (n = 118 control, n = 116 intervention), and b box plot showing the distribution of utility scores by trial arm over the trial period (n = 118 control, n = 116 intervention). The box plots show the median (centre line), the first and third quartiles (the lower and upper bounds of the box), and the whiskers show 1.5× the interquartile range. Points beyond the whiskers are ‘outlying’ points plotted individually. Source data are provided with this paper.
Fig. 2
Fig. 2. Healthcare resource utilisation by trial arm at baseline, 3 months, and 6 months after randomisation.
a shows the mean resource use per participant over the trial period, by trial arm, with standard error shading (n = 118 control, n = 116 intervention); b shows box plots of the distribution of resource use costs among participants over the trial period, by trial arm (n = 118 control, n = 116 intervention). The box plots show the median (centre line), the first and third quartiles (the lower and upper bounds of the box), and the whiskers show 1.5× the interquartile range. Points beyond the whiskers are ‘outlying’ points plotted individually. c is a bar chart showing resource use category cost drivers over the trial period, by trial arm (n = 118 control, n = 116 intervention). Source data are provided with this paper.
Fig. 3
Fig. 3. Hours of work missed due to sickness by trial arm, at baseline, 3 months, and 6 months after randomisation (n = 118 control, n = 116 intervention).
a Bar chart showing the total number of hours of work missed, by trial arm; b line graph showing mean number of hours of work missed per participant, by trial arm, with standard error shading. Source data are provided with this paper.
Fig. 4
Fig. 4. Incremental cost-effectiveness ratio (ICER) Planes and cost-effectiveness acceptability curves (CEACs) for the National Health Service and Personal Social Services (NHS/PSS) and societal perspectives using 5000 non-parametric bootstrap replicates on 10 imputed datasets from an original sample of n = 234 individuals (n = 118 control, n = 116 intervention).
Each individual had three scheduled observations, with a total of 37/702 missing observations (1/354 missing observation in the control arm, 36/348 missing observations in the intervention arm). a ICER Plane from the NHS/PSS perspective. b CEAC from the NHS/PSS perspective. c ICER Plane from the societal perspective. d CEAC Plane from the societal perspective. QALY: Quality-adjusted life year.
See this image and copyright information in PMC

References

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