¹Zürich University of Applied Sciences, Winterthur Institute of Health Economics, Zürich, Switzerland
²Zürich University of Applied Sciences, Institute of Public Health, Zürich, Switzerland
³University of Queensland, Brisbane, Australia
⁴Zürich University of Applied Sciences, Zürich, Switzerland
⁵University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
⁶University of Bern, Institute of Psychology, Bern, Switzerland
⁷Queensland University of Technology, Brisbane, Australia
⁸University of Southern Denmark, Odense, Denmark

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Introduction: Neck pain is a significant public health issue, especially among office workers, with a prevalence ranging from 42 to 68%. This study aimed to evaluate the cost-utility and cost-benefit of a multi-component intervention targeting neck pain in the general population of office workers in Switzerland. The 12-week multi-component intervention consisted of neck exercises, health promotion information workshops, and workplace ergonomics sessions.

Methods: The study was designed as a stepped-wedge cluster randomized controlled trial and assessed using an employer’s perspective. The main analysis focused on the immediate post-intervention period. Long-term effects were examined in a subsample at the 4, 8, and 12-month follow-ups. The intervention effects on costs and quality adjusted life years (QALYs) were estimated using generalized linear mixed-effects models, controlling for confounding factors. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves were presented, along with calculations of the break-even point and the return on investment. Various sensitivity analyses were performed.

Results: A total of 120 office workers participated in the trial, with 100 completing the intervention period and 94 completing the entire study. The main analysis included 392 observations. The intervention had a significant positive effect on QALYs and a nonsignificant effect on costs. The ICER was estimated at -25,325 per QALY gain, and the probability of the intervention being cost saving was estimated at 88%.

Discussion: Assumptions needed to calculate the break-even point and estimated savings one year after the program terminated were that productivity gains remained stable and uniformly distributed throughout the year following the intervention. Under this assumption, two key findings stand out: Firstly, the program reaches its break-even point on average one week (6.4 days) after the intervention ends, indicating that the financial benefits from increased employee productivity offset the program costs within just over six days. Secondly, within one-year post-intervention, the program costs remain at CHF 770.5 per employee, while expected savings from productivity gains are estimated at CHF 2,829.5 per employee. This translates to a projected return of CHF 3.67 for each CHF invested, driven by improved employee productivity due to reduced neck pain.

Conclusion: The multi-component intervention is likely to reduce company costs and simultaneously improve the quality of life of employees. However, the implementation of such interventions critically depends on evidence of their cost-effectiveness. As there is still a large research gap in this area, future studies are needed.