Cost-Effectiveness of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients With...

Area of Science:

• Public Health
• Health Economics
• Behavioral Science

Background:

• The BE ACTIVE trial assessed interventions like gamification and financial incentives to boost physical activity (daily steps/day) in individuals at high risk for cardiovascular disease.
• Increased daily steps correlate with enhanced life expectancy, but cost-effectiveness data is crucial for widespread implementation.

Purpose of the Study:

• To evaluate the lifetime cost-effectiveness of gamification, financial incentives, and combined approaches versus attention control for increasing physical activity.
• To compare the cost-effectiveness of each intervention arm, including attention control, against no intervention.

Main Methods:

• A probabilistic Markov model was employed to estimate life-years and quality-adjusted life-years gained from interventions.
• Three durability scenarios (optimistic, intermediate, pessimistic) were modeled to account for the unknown long-term impact of increased steps/day post-intervention.

Main Results:

• Gamification intervention costs were $938/participant, with cost-effectiveness ranging from $261 to $30,550 per life-year gained compared to attention control.
• Gamification alone consistently demonstrated a cost-effectiveness below $50,000 per life-year gained across all durability scenarios when compared to no intervention.
• Financial incentives were dominated by other interventions, and gamification+financial incentives were cost-effective only in optimistic and intermediate scenarios.

Conclusions:

• Gamification interventions represent a high-value strategy for increasing physical activity and improving life expectancy, aligning with established cost-effectiveness thresholds.
• The findings support the integration of gamification into public health strategies for cardiovascular disease prevention due to its favorable economic value.