Cost-effectiveness of a proportionate universal offer of free exercise: Leeds Let’s Get Active

Paolo Candio, David Meads, Andrew Hill, Laura Bojke

Research output: Contribution to journalArticlepeer-review


Objectives To assess the cost-effectiveness of a proportionate universal programme to reduce
physical inactivity (Leeds Let’s Get Active) in adults.
Methods A continuous-time Markov chain model was developed to assess the cost implications and
QALY gains associated with increases in physical activity levels across the adult population. An
ordered logistic model was specified to estimate the effectiveness of the Leeds Let’s Get Active
programme and derive transition probabilities between physical activity categories. A parametric
survival analysis approach was applied to estimate the decay of intervention effect over time.
Baseline model data were obtained from previous economic models, population-based surveys and
other published literature. A cost-utility analysis was conducted from a health care sector perspective
over the programme duration (39 months). Scenario and probabilistic sensitivity analyses were
performed to test the robustness of cost-effectiveness results.
Results 51,874 adult residents registered to the programme and provided baseline data, 19.5% of
which were living in deprived areas. Under base case assumptions, Leeds Let’s Get Active was found
to be likely to be cost-effective. However, variations in key structural assumptions showed sensitivity
of the results.
Conclusions Evidence from this study suggests that a universal offer of access to free off-peak leisure
centre-based exercise that targets hard to reach groups can provide good value for money. Further
data collection is needed to reduce the uncertainty surrounding the decision.
Original languageEnglish
Article numberfdaa113
Number of pages11
JournalJournal of public health
Early online date5 Aug 2020
Publication statusE-pub ahead of print - 5 Aug 2020

Bibliographical note

© The Author(s) 2020. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

Cite this