Cost effectiveness of a pragmatic exercise intervention (EXIMS) for people with multiple sclerosis: Economic evaluation of a randomised controlled trial
Background: Exercise is a safe, non-pharmacological adjunctive treatment for people with multiple sclerosis but costeffectiveapproaches to implementing exercise within health care settings are needed.Objective: The objective of this paper is to assess the cost effectiveness of a pragmatic exercise intervention inconjunction with usual care compared to usual care only in people with mild to moderate multiple sclerosis.Methods: A cost-utility analysis of a pragmatic randomised controlled trial over nine months of follow-up was conducted.A total of 120 people with multiple sclerosis were randomised (1:1) to the intervention or usual care. Exercisingparticipants received 18 supervised and 18 home exercise sessions over 12 weeks. The primary outcome for the costutility analysis was the incremental cost per quality-adjusted life year (QALY) gained, calculated using utilities measuredby the EQ-5D questionnaire.Results: The incremental cost per QALY of the intervention was £10,137 per QALY gained compared to usual care.The probability of being cost effective at a £20,000 per QALY threshold was 0.75, rising to 0.78 at a £30,000 per QALYthreshold.Conclusion: The pragmatic exercise intervention is highly likely to be cost effective at current established thresholds,and there is scope for it to be tailored to particular sub-groups of patients or services to reduce its cost impact. © The Author(s) 2013.