Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up.
Louisa G GordonElizabeth G EakinRosalind R SpenceChristopher PykeJohn BashfordChristobel SaundersSandra C HayesPublished in: International journal of environmental research and public health (2020)
Studies show conflicting results on whether exercise interventions to improve outcomes for women with breast cancer are cost-effective. We modelled the long-term cost-effectiveness of the Exercise for Health intervention compared with usual care. A lifetime Markov cohort model for women with early breast cancer was constructed taking a societal perspective. Data were obtained from trial, epidemiological, quality of life, and healthcare cost reports. Outcomes were calculated from 5000 Monte Carlo simulations, and one-way and probabilistic sensitivity analyses. Over the cohort's remaining life, the incremental cost for the exercise versus usual care groups were $7409 and quality-adjusted life years (QALYs) gained were 0.35 resulting in an incremental cost per QALY ratio of AU$21,247 (95% Uncertainty Interval (UI): Dominant, AU$31,398). The likelihood that the exercise intervention was cost-effective at acceptable levels was 93.0%. The incremental cost per life year gained was AU$8894 (95% UI Dominant, AU$11,769) with a 99.4% probability of being cost effective. Findings were most sensitive to the probability of recurrence in the exercise and usual care groups, followed by the costs of out-of-pocket expenses and the model starting age. This exercise intervention for women after early-stage breast cancer is cost-effective and would be a sound investment of healthcare resources.
Keyphrases
- healthcare
- high intensity
- physical activity
- early stage
- resistance training
- randomized controlled trial
- palliative care
- sensitive detection
- quality improvement
- public health
- monte carlo
- early breast cancer
- study protocol
- reduced graphene oxide
- electronic health record
- rectal cancer
- lymph node
- affordable care act
- health information
- adipose tissue
- machine learning
- weight loss
- smoking cessation
- insulin resistance
- risk assessment