Economic Evaluation of an Indicated Prevention Strategy Focused on Future Long-Term Sickness Absence

An indicated prevention strategy (IPS) targeting long-term sickness absence risk showed its effectiveness in a randomized controlled trial (RCT). To compare its costs and benefits with other preventive strategies within occupational health, an economic evaluation is essential.

An economic evaluation was conducted from the employer, healthcare, and societal perspectives. RCT data was used regarding the IPS efficacy, with additional collected data, covering 12 months of follow-up. The intervention group received an early intervention (n=132), and the care-as-usual group received care upon request (n=131). Self-perceived health was used as effect measure; costs encompassed: intervention, healthcare, patient and family, and productivity costs (absenteeism). The cost price year for the study was 2020. Different types of sensitivity analysis were conducted.

At 12 months of follow-up, the intervention group showed greater effects and higher costs, indicating positive incremental cost-effectiveness ratios (ICERs) of €39.19 and €39.77 per point improvement of self-perceived health, seen from the societal and healthcare perspective. Using the employer perspective, the ICER for the IPS was dominant (preferred) to the control, with (€-3.92) per point improvement of self-perceived health, indicating greater effects and lower costs, related to the net savings for the employer due to reduced sickness absence.

The economic evaluation showed that the IPS had an economic benefit over the care as usual, as seen from the employer's perspective. In addition, this approach indicates a way towards a balanced comparison of preventive interventions, which is to prioritize the most relevant preventive actions.