COST-BENEFIT ANALYSIS OF INCREASING POPULATION PHYSICAL ACTIVITY FOR CARDIOMETABOLIC DISEASE PREVENTION IN SAUDI ARABIA
Author(s)
Bander Balkhi, PharmD, PhD.
Faculty Advisor, King Saud University, Riyadh, Saudi Arabia.
Faculty Advisor, King Saud University, Riyadh, Saudi Arabia.
OBJECTIVES: To estimate the societal economic value of increasing population-level physical activity in Saudi Arabia by modeling downstream cardiometabolic health and economic outcomes.
METHODS: A societal cost-benefit analysis was conducted using a cohort Markov model simulating 100,000 adults aged 40-70 years over 10 years with 3% annual discounting. Health states were healthy/at risk, type 2 diabetes mellitus (DM), cardiovascular disease (CVD), and death. The intervention was defined as a counterfactual 10-percentage-point shift from low physical activity to achieving ≥150 minutes/week of moderate-intensity activity. Published relative-risk estimates for DM, CVD, and mortality were applied to transition probabilities. Saudi Arabia-specific disease burden estimates informed baseline risks. To reduce double counting across correlated cardiometabolic pathways, risk reductions were adjusted for overlapping DM and CVD attribution. A 50% attenuation factor reflected implementation, adherence, and sustainability constraints. Direct medical costs were based on national tariff estimates, and indirect costs were estimated using a conservative human-capital approach. Parameter uncertainty was assessed using probabilistic sensitivity analysis with 10,000 Monte Carlo simulations.
RESULTS: The physical activity scenario generated discounted implementation costs of SAR 130 million (95% uncertainty interval 110-150 million) and total societal benefits of SAR 780 million (95% UI: 620-1,020 million) over 10 years. Benefits were driven primarily by avoided CVD burden, followed by diabetes-related medical cost offsets and productivity gains. The net present value was SAR 650 million (95% UI: 450-890 million), and the benefit-cost ratio was 6.0 (95% UI: 3.8-8.7). The intervention was cost-beneficial in 95.4% of probabilistic simulations.
CONCLUSIONS: A modest population-level increase in physical activity in Saudi Arabia was projected to generate substantial societal economic value through reduced cardiometabolic disease burden. Findings support physical activity promotion as a high-value upstream prevention strategy, while emphasizing the importance of implementation effectiveness and sustained population uptake.
METHODS: A societal cost-benefit analysis was conducted using a cohort Markov model simulating 100,000 adults aged 40-70 years over 10 years with 3% annual discounting. Health states were healthy/at risk, type 2 diabetes mellitus (DM), cardiovascular disease (CVD), and death. The intervention was defined as a counterfactual 10-percentage-point shift from low physical activity to achieving ≥150 minutes/week of moderate-intensity activity. Published relative-risk estimates for DM, CVD, and mortality were applied to transition probabilities. Saudi Arabia-specific disease burden estimates informed baseline risks. To reduce double counting across correlated cardiometabolic pathways, risk reductions were adjusted for overlapping DM and CVD attribution. A 50% attenuation factor reflected implementation, adherence, and sustainability constraints. Direct medical costs were based on national tariff estimates, and indirect costs were estimated using a conservative human-capital approach. Parameter uncertainty was assessed using probabilistic sensitivity analysis with 10,000 Monte Carlo simulations.
RESULTS: The physical activity scenario generated discounted implementation costs of SAR 130 million (95% uncertainty interval 110-150 million) and total societal benefits of SAR 780 million (95% UI: 620-1,020 million) over 10 years. Benefits were driven primarily by avoided CVD burden, followed by diabetes-related medical cost offsets and productivity gains. The net present value was SAR 650 million (95% UI: 450-890 million), and the benefit-cost ratio was 6.0 (95% UI: 3.8-8.7). The intervention was cost-beneficial in 95.4% of probabilistic simulations.
CONCLUSIONS: A modest population-level increase in physical activity in Saudi Arabia was projected to generate substantial societal economic value through reduced cardiometabolic disease burden. Findings support physical activity promotion as a high-value upstream prevention strategy, while emphasizing the importance of implementation effectiveness and sustained population uptake.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE323
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)