Economic burden of low cardiorespiratory fitness in France

BACKGROUND: Estimating the economic burden of low cardiorespiratory fitness (CRF) may help quantify its impact on healthcare costs and productivity losses. The aim of this study was to assess the economic burden of low CRF in France. The second objective was to estimate the cost savings associated with a 10% reduction in the prevalence of low CRF. METHODS: A prevalence-based approach was used to quantify the direct (health care) costs of low CRF, with direct costs estimated using data from the French National Health Insurance system. Indirect costs (productivity losses due to premature mortality or morbidity) were assessed using a friction cost approach. The same methodology was applied to model the economic impact of a 10% reduction in the prevalence of low CRF. RESULTS: Some 26.9% of males and 63.1% of females were identified as having low CRF in France. In 2024, the most expensive NCDs attributable to low CRF in terms of direct costs were type 2 diabetes (€ 1.993 billion), heart failure (€ 1.598 billion) and dementia (€ 1.137 billion). The total direct costs attributable to low CRF represented 5.6% of the total annual National Health expenditure in 2024. Indirect costs attributable to low CRF were estimated at € 4.775 billion. A 10% absolute reduction in low CRF would result in an estimated avoided cost (direct and indirect) of € 3.090 billion (18.9%) per year. CONCLUSIONS: Low CRF represents a substantial economic burden in France. Improving CRF at the population level could generate significant health and productivity savings.