Cost-Effectiveness of a Cardiac Rehabilitation Program Specifically Designed for Patients With Obesity Within the OPTICARE XL Randomized Controlled Trial

Objective: To assess the cost-effectiveness of a cardiac rehabilitation (CR) program specifically designed for cardiac patients with obesity vs standard CR.Design: Cost-effectiveness analysis based on observations in a randomized controlled trial.Setting: Three regional CR centers in the Netherlands. Participants: Cardiac patients (N=201) with obesity (BMI & GE;30 kg/m2) referred to CR. Interventions: Participants were randomized to a CR program specifically designed for patients with obesity (OPTICARE XL; N=102) or stan-dard CR. OPTICARE XL included aerobic and strength exercise and behavioral coaching on diet and physical activity during 12 weeks, followed by a 9-month after-care program with booster educational sessions. Standard CR consisted of a 6-to 12-week aerobic exercise program, supple-mented with cardiovascular lifestyle education.Main Outcome Measures: An economic evaluation, with an 18-month time horizon, in terms of quality-adjusted life years (QALYs) and costs from the societal perspective was performed. Costs were reported in 2020 Euros, discounted at a 4% annual rate, and health effects were dis-counted at a 1.5% annual rate.Results: OPTICARE XL CR and standard CR resulted in comparable health gain per patient (0.958 vs 0.965 QALYs, respectively; P=.96). Over-all, OPTICARE XL CR saved costs (-euro4542) compared with the standard CR group. The direct costs for OPTICARE XL CR were higher than for standard CR (euro10,712 vs euro9951), whereas indirect costs were lower (euro51,789 vs euro57,092), but these differences were not significant.Conclusions: This economic evaluation showed no differences between OPTICARE XL CR and standard CR in health effects and costs in cardiac patients with obesity.Archives of Physical Medicine and Rehabilitation 2023;104:855-62 & COPY; 2023 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Automated summary

The objective of this study was to compare the cost-effectiveness of a cardiac rehabilitation program specifically designed for obese cardiac patients with the standard cardiac rehabilitation program. A cost-effectiveness analysis was conducted based on observations from a randomized controlled trial. The results showed that there were no differences in health effects and costs between the two programs.