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Randomized Controlled Trial
. 2020 Nov 19;17(22):8608.
doi: 10.3390/ijerph17228608.

Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up

Louisa G Gordon  1   2   3 , Elizabeth G Eakin  3 , Rosalind R Spence  4 , Christopher Pyke  5 , John Bashford  6 , Christobel Saunders  7 , Sandra C Hayes  4
Affiliations
Randomized Controlled Trial

Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up

Louisa G Gordon et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: breast cancer; cost-effectiveness analysis; cost-utility analysis; exercise.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Illustration of Markov model health states.
Figure 2
Figure 2
Probabilistic sensitivity analyses, incremental cost per QALY gain scatterplot. AU$ = Australian dollars, QALY = quality-adjusted life year.
Figure 3
Figure 3
Cost-effectiveness acceptability curves.
Figure 4
Figure 4
One-way sensitivity analyses; incremental cost per QALY gain.
See this image and copyright information in PMC

References

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