OBJECTIVES: The Physical Activity Loyalty (PAL) scheme is a public health intervention aiming to increase physical activity in workplaces by providing financial incentives to employees. The objective of this study was to conduct an economic evaluation alongside a cluster randomised controlled trial comparing the PAL scheme and the control group, using both a cost-utility framework from the public sector perspective and a cost-benefit framework from the employer’s perspective.

METHODS: RESULTS: The intervention was £25.85 (95%CI -29.89,81.60) more costly per participant but had no effect on QALYs (incremental QALY=-0.0000891,95%CI -0.008,0.008). The bootstrapped cost and QALY pairs spread over the four quadrants of the cost-effectiveness plane indicating large uncertainty. Nevertheless, the intervention appears likely to be cost-effective in the subgroup that had a high level of availability of physical activity opportunities with 76.8% bootstrapped iterations generating a cost-effective estimate under the £20,000/QALY threshold. Besides, the intervention group was estimated to reduce absenteeism by 2.59 hours (p=0.62) per month compared with the control group. At current intervention costs (=£55.68), the probability that the PAL scheme is cost saving for employers is 57%-64% for employees with low to high salary levels.

CONCLUSIONS: There was large variability across participants in their resource use and especially utility values, leading to a great uncertainty in the cost-effectiveness estimate. A personalized HTA approach is warranted in future studies to provide recommendations with a greater certainty.