Financial incentives for exercise and medical care costs

Physical inactivity has become a public health priority in many developed countries to address large disease burdens from noncommunicable diseases and the associated financial costs. Policymakers are interested in incentive programs that use behavioral science insights to address the lack of exercise in citizens. However, as considerable resources are required for incentive payments and administration, determining the cost-effectiveness or return on investment of disseminating such programs is critical. This study evaluates the economic effects and costs of an incentive-based exercise program using data derived from the project conducted in six Japanese municipalities between 2014 and 2015, analyzing medical care costs as the project’s outcomes. By using a doubly robust difference-in-difference estimator, we found that the average treatment effects of the reduction in medical care costs due to the project were particularly evident for women, yielding a decline of 58,000 JPY. In total, the project was expected to save short-term medical care costs by 465 million JPY. Similarly, age-specific analysis showed medical care cost reductions of 56,200 JPY for those in their 60 s and 58,400 JPY for those in their 70 s, and these figures resulted in saving short-term medical care costs by 450 million JPY in total. With operational budgeted costs of 180 million JPY, including the fee for incentive payments, the short-term economic benefits of the project were significant and positive.