A Review of the Cost-Effectiveness of Supervised Exercise Therapy for Adults with Chronic Conditions in the United States
Context
As healthcare costs rise, supervised exercise therapy (SET) that is individually tailored and delivered in small-group programs can be a cost-effective intervention. However, few economic evaluations have focused on physical activity interventions.
Objective
This review systematically evaluated the cost-effectiveness of SET programs for US adults with chronic conditions (cancer, depression/anxiety, hypertension, diabetes, obesity, or increased risk of falls).
Design
An electronic literature search was conducted in June 2024 using PubMed, SCOPUS, and PsycINFO databases for articles published from January 1, 2004, to June 5, 2024. The protocol was registered with PROSPERO (CRD42024534657).
Eligibility Criteria
Included articles were original, full-text economic evaluations of SET programs for US adults with chronic conditions compared with usual care, nonsupervised exercise, or other treatments.
Main Outcome Measures
Primary outcomes were cost-effectiveness metrics and health outcomes, including return on investment (ROI), cost savings from reduced healthcare costs, and improvements in chronic condition management through supervised exercise. Additional outcomes included total costs, healthcare utilization, and health benefit differences between intervention and comparator groups.
Results
A narrative synthesis was used to summarize findings due to heterogeneity across studies. This review included eight studies: four randomized clinical trials, three modeling studies, and one retrospective cohort study. Intervention periods ranged from 7 wk to 3 yr, with follow-up from 12 wk to 3 yr. Studies included the intended target populations and community, assisted living, and hospital settings. Sample sizes ranged from 15 to over 3000 individuals. The review showed consistent, positive ROI (1.15:1 to 1.7:1), and cost savings ($121–$2834) through reduced healthcare costs or treatment charges.
Conclusion
SET programs are cost-effective across chronic conditions and settings, with positive ROI and economic benefits supporting broader public health implementation. Future research should standardize economic evaluation methods in SET studies for comparison across diverse interventions, settings, and populations.
Whitsel, L. P., Chase, P. J., Stoner, L., Barclay, J., Huang, M., Kariuki, J., Ajibewa, T., Stoutenberg, M., Owen, C. M., Bantham, A., & McNamara, G. (2025). A Review of the Cost-Effectiveness of Supervised Exercise Therapy for Adults with Chronic Conditions in the United StatesTranslational Journal of the American College of Sports Medicine, 10(3). https://doi.org/10.1249/TJX.0000000000000313
