Economic Evaluation of an Indicated Prevention Strategy Focused on Future Long-Term Sickness Absence.

PURPOSE: An indicated prevention strategy (IPS) targeting long-term sickness absence risk showed its effectiveness in a randomized controlled trial (RCT). To compare its costs and benefits with other preventive strategies within occupational health, an economic evaluation is essential. METHODS: An economic evaluation was conducted from the employer, healthcare, and societal perspectives. RCT data was used regarding the IPS efficacy, with additional collected data, covering 12 months of follow-up. The intervention group received an early intervention (n=132), and the care-as-usual group received care upon request (n=131). Self-perceived health was used as effect measure; costs encompassed: intervention, healthcare, patient and family, and productivity costs (absenteeism). The cost price year for the study was 2020. Different types of sensitivity analysis were conducted. RESULTS: At 12 months of follow-up, the intervention group showed greater effects and higher costs, indicating positive incremental cost-effectiveness ratios (ICERs) of €39.19 and €39.77 per point improvement of self-perceived health, seen from the societal and healthcare perspective. Using the employer perspective, the ICER for the IPS was dominant (preferred) to the control, with (€-3.92) per point improvement of self-perceived health, indicating greater effects and lower costs, related to the net savings for the employer due to reduced sickness absence. CONCLUSION: The economic evaluation showed that the IPS had an economic benefit over the care as usual, as seen from the employer's perspective. In addition, this approach indicates a way towards a balanced comparison of preventive interventions, which is to prioritize the most relevant preventive actions.