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Gaceta Sanitaria

Print version ISSN 0213-9111


ŠPACIROVA, Zuzana et al. Cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. The FLAMENCO Project. Gac Sanit [online]. 2019, vol.33, n.6, pp.529-535.  Epub Jan 27, 2020. ISSN 0213-9111.


Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women.


A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System. Health outcomes were quality-adjusted life years (QALYs), measured by the EuroQol-5D-5L questionnaire. The total direct costs of the programme were the costs of visits to primary care, specialty care, emergency, medicines, instructor cost and infrastructure cost. The results were expressed as the incremental cost-effectiveness ratio. Sensitivity analysis was undertaken to test the robustness of the analysis.


Mean QALYs over 16 weeks were.228 in the control group and.230 in the intervention group (mean difference: .002; 95% confidence interval [95%CI]: −0.005 to 0.009). Improvements from baseline were greater in the intervention group in all dimensions of the EuroQol-5D-5L but not statistically significant. The total costs at the end of the intervention were 160.38 € in the control group and 167.80 € in the intervention group (mean difference: 7.42 €; 95%CI: −47 to 62). The exercise programme had an incremental cost-effectiveness ratio of 4,686 €/QALY.


The programme could be considered cost-effective, although the overall difference in health benefits and costs was very modest. Longer term follow-up is needed.

Keywords : Cost-benefit analysis; Quality-adjusted life years; Menopause; Exercise; Women.

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