Exercise as therapy: Professorship of Health Economics publishes study in “The Lancet Psychiatry”

An interdisciplinary research team from the Technical University of Munich has conducted and published a new study on the effectiveness and cost-effectiveness of exercise-based therapeutic approaches for mental health conditions in one of the world’s leading academic journals. The article, titled “Cost-effectiveness of a transdiagnostic group exercise intervention for mental health in Germany (ImPuls trial): an economic evaluation study”, appeared in the journal “The Lancet Psychiatry”, which has an impact factor of 24.8.

The first author of the study is Dr. Sebastian Himmler, a Research Associate at the Professorship of Health Economics. The last author is Prof. Dr. Leonie Sundmacher, head of the Professorship of Health Economics. The work was conducted as part of a project funded by the Innovation Fund of the Joint Federal Committee and in close collaboration with an interdisciplinary research team.

Exercise as a complementary therapy option for mental health conditions

Mental illnesses such as depression, anxiety disorders, or post-traumatic stress disorder pose a significant health and economic challenge worldwide. At the same time, existing care options are often associated with barriers to access or demonstrate limited effectiveness.

This study therefore examines the “ImPuls” intervention — a structured, group-based exercise program for patients with various mental illnesses. The focus was particularly on the health economic assessment.

“In the study, we conducted a comprehensive health economic evaluation, taking into account not only costs but also quality of life and care aspects,” explains Dr. Himmler. “The cost analysis is based on routine data from health insurance companies, which enables a particularly realistic assessment.”

Significant health benefits with moderate additional costs

The analysis is based on data from a large randomized controlled trial involving approximately 400 participants in an outpatient setting in Germany. The study examined a six-month training program that combined supervised and independent exercise sessions, behavioral strategies, and digital support. Group-based training sessions took place only during the first four weeks, followed by ongoing support via an app, among other means.

The results show that participants in the intervention group benefited significantly more than the comparison group, which received only standard care. Mental health symptoms decreased significantly, and health-related quality of life also improved measurably.

After twelve months, there was an additional improvement of 3.78 points on an established scale for measuring psychological distress (BSI-18), as well as a gain in health-related quality of life, measured in so-called Quality-Adjusted Life Years (QALYs).

At the same time, total costs were moderately higher: on average, additional costs of around 553 euros per patient were incurred. This results in a cost-benefit ratio of approximately 17,543 euros per QALY gained.

“The intervention does not lead to immediate cost savings, as its implementation initially incurs additional expenses,” said Dr. Himmler. “At the same time, however, we see a clear positive effect on the participants’ quality of life. From a health economic perspective, the measure can therefore be considered cost-effective.”

High Relevance for Care

A key finding of the study is the high probability that the intervention can be classified as cost-effective—especially when compared to common international thresholds.

“Our results suggest that exercise-based interventions can serve as a meaningful complement to existing care,” emphasizes Dr. Himmler. “From a health economic perspective, we therefore recommend integrating such programs into standard care in the future.”

Implications for Research and Health Policy

For the first time, the study provides robust evidence on the cost-effectiveness of a transdiagnostic exercise intervention that addresses multiple mental health conditions simultaneously.

“With the ImPuls approach, we demonstrate that innovative and comparatively low-threshold interventions can be both effective and economically viable,” says Prof. Sundmacher. “Especially in the field of mental health, it is crucial to develop new forms of care that reach patients at an early stage.”

Furthermore, Prof. Sundmacher highlights the relevance to health policy: “The results provide important insights for the further development of care. Interdisciplinary approaches that combine prevention, exercise, and therapy can help close gaps in care in the long term.” The Innovation Committee of the Joint Federal Committee also supports further steps toward integrating “ImPuls” into standard care.
 

To the publication in the journal “The Lancet Psychiatry”

To the homepage of the Professorship of Health Economics

To the text of the Innovation Committee’s resolution
 

Contact:

Prof. Dr. Leonie Sundmacher
Professorship of Health Economics
Am Olympiacampus 11
80809 Munich

Tel.: 089 289 24464
Email: leonie.sundmacher(at)tum.de

Dr. Sebastian Himmler
Professorship of Health Economics
Am Olympiacampus 11
80809 Munich

Tel.: 089 289 24465
Email: sebastian.himmler(at)tum.de

Text: Romy Schwaiger
Photos: “The Lancet Psychiatry”/Silvia Béres (Beres Fotografie)