10. Studies reporting an economic analysis related to the cost of the intervention and/or fall outcomes.
Study ID, (source if not primary reference), sample, comparison, type of evaluation |
Intervention(s) and comparator (n in analyses) | Perspectives, type of currency, price year, time horizon | Cost items measured | Intervention costs per participant | Healthcare service costs per participant |
Incremental cost per fall prevented/ per QALY gained |
Exercise trials | ||||||
Canning 2015a (Farag 2016) People with PD who had fallen at least once in the past year or were at risk of falls. Gait, balance and functional training vs control Evaluated with cost‐effectiveness analyses |
Exercise (balance, lower limb strength, and when required cueing), 3 X week, 24 weeks, with 6‐10 sessions supervised either individually or in a group setting (n = 113) vs usual care control (n = 113) | Health system perspective, Australian dollar, 2012, During 6‐month trial period |
Intervention costs (staff time, travel, equipment) Health service use costs (hospital, medical, allied health) Medication costs |
$A1,010 (€642) |
Exercise group $A4,604 (€2,925) Control group $A3,920 (€2,491) |
Cost per fall prevented $A574 (€365) Cost per QALY gained $A338,800 (€215,277) |
Chivers Seymour 2019 (Ashburn 2019, Xin 2020) People with PD who had fallen at least once in the past year. Gait, balance and functional training vs control Evaluated with cost‐effectiveness analyses |
Exercise (balance and lower limb strengthening exercises, plus strategies for preventing falls and reducing freezing of gait), 30 min per day for 6 months, including 12 x 1‐1.5 hour supervised sessions with a physiotherapist (n = 238) vs usual care control (n = 236) | United Kingdom National Health Service and Personal Social Services perspectives, Pound Stirling, 2016, During 6 month intervention period |
Intervention costs (physiotherapist salaries, training, travel, equipment and consumables) Health service use (hospital, primary care, social service) Medication costs collected but not included in analyses |
£650 (€765) | Exercise group £3,137 (€3,905) Control group £3,069 (€3,613) |
Cost per QALY gained £120,659 (€142,063) |
Gandolfi 2017 People with PD, both fallers and non‐fallers. Gait, balance and functional training (virtual reality telerehabilitation) vs Gait, balance and functional training (balance training in a facility) Evaluated with cost analysis |
Virtual reality balance training (using Nintendo Wii Fit system, Nintendo Co., Ltd., Kyoto, Japan) delivered via telehealth (using Skype, Microsoft, USA), delivered in pairs (n = 36) vs sensory‐integration balance training delivered in‐person, individually (n = 34), both interventions 50 mins, 3 X week, 7 weeks | Cost of rehabilitation perspective, Euros, Price year not reported, During assessments and 7 week intervention period |
Direct costs (personnel for screening, assessments and intervention, plus resource utilisation). Indirect costs (utilities, facilities) |
Virtual reality via telehealth balance training (delivered in pairs) €383.55 sensori‐integration balance training (delivered individually) €602.10 |
Not reported | Not reported |
Goodwin 2011 (Fletcher 2012) People with PD and 2 or more falls in the preceding year. Gait, balance and functional training vs control Evaluated with cost‐effectiveness analyses |
Exercise (balance, lower limb and trunk strength, 1 X week supervised group and 2 X week independent at home for 10 weeks (n=48) vs usual care control (n = 45). Economic analyses conducted with intervention n = 48 and control n = 45 |
United Kingdom National Health Service and Personal Social Services perspectives, Pound sterling, 2008/9, During 20 weeks (10 weeks intervention and 10 weeks follow‐up) |
Intervention costs (staff time, travel, equipment, venue hire) Health service use (hospital, primary care, social service) Medication costs |
£76 (€89) | Exercise group Health care cost £1,198 (€1,410) Health and social care cost £1,444 (€1,700) Control group Health care cost £1,320 (€1,554) Health and social care cost £1,479 (€1,741) |
Cost per QALY gained for total health care costs ‐£4,885 (‐€5,752) Cost per QALY gained for combined total health care and social care costs ‐£1,358 (‐€1,599) |
Li 2012 (Li 2015b) People with PD, both fallers and non‐fallers. 3D exercise (Tai Chi) / resistance training (functional strength) vs control Evaluated with cost‐effectiveness analyses |
Tai Chi (n=65) vs resistance training (n=65) vs stretching (control) (n=65), all group classes for 60 minutes, 2 X week, 24 weeks | Societal perspective, United States dollar, 2011, During 9 months (6 months intervention and 3 months follow‐up) |
Intervention costs (program promotion, recruitment, staff time, insurance, equipment, room hire, printed materials) Non‐intervention costs (PD medication, physical therapy, medical treatment for falls, participant travel) |
Tai chi $US1,080 (€952) Resistance $US1,186 (€1,046) Stretching $US1,155 (€1,019) |
PD medication, physical therapy, medical treatment for falls and participant travel costs: Tai chi $US272 (€240) Resistance $US310 (€273) Stretching $US726 (€640) |
Tai chi vs stretching (control): Cost per fall prevented ‐$US175 (‐€154) Cost per QALY gained ‐$US3,394 (‐€2,993) Resistance vs Tai Chi: Cost per fall prevented $US100 (€88) Cost per QALY gained $US1,236 (€1,090) |
Munneke 2010 People with PD, both fallers and non‐fallers. Other exercise (ParkinsonNet therapists) vs Other exercise (standard therapists) Evaluated with cost analysis |
Treatment from ParkinsonNet trained physiotherapists (n=343 to 350)* vs usual care (treatment from physiotherapists without specific PD training) (n=332‐340)*, both groups 24 weeks intervention period | Societal perspective, Euro, Price year not reported, but data collected 2005‐2007, During 24 weeks intervention |
Health care costs (physiotherapy, medication, consultation, day‐hospital rehabilitation, admission to hospital, home‐care (paid services), informal care, costs due to lost productivity of the care‐partner). | Physiotherapy cost: ParkinsonNet group €297 Usual care group €310 |
Excluding physiotherapy: ParkinsonNet group €2,674 Usual care group €3,424 |
Not calculated |
Exercise plus education trial | ||||||
Morris 2017 People with PD, both fallers and non‐fallers. Gait, balance and functional training plus education vs control Evaluated with cost analysis |
Exercise (strength training (lower limb and trunk), movement strategy training) and falls prevention education, 1 X week 60 mins supervised and 1 X week 60 mins independent practice for 6 weeks (n=67) vs Life Skills program (control) (n=66) | Health system perspective, Australian dollar, 2016, During 12 months follow‐up |
Intervention costs (travel, home visits, therapist training, equipment). Life skills control intervention was considered as a placebo and therefore had no costs attributed to it. Medical costs associated with falling events (medical, medical ancillary, diagnostic and hospitalisation costs) |
$A1,596 (€1,013) | Not reported | Not calculated as there was no difference between the groups |
*Different participant numbers for different cost components
Where costs were reported in a currency other than EUR, the cost was converted to EUR (€) on December 23, 2021.
QALY = quality‐adjusted life‐year