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, Elizabeth G. Eakin, Rosalind R. Spence, Christopher Pyke, John Bashford, Christobel Saunders and Sandra C. Hayes
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Louisa G. Gordon: Population Health Department, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, Qld 4029, Australia
Elizabeth G. Eakin: Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Brisbane, Qld 4006, Australia
Rosalind R. Spence: Menzies Health Institute Qld, Griffith University, Nathan, Brisbane, Qld 4111, Australia
Christopher Pyke: Mater Public and Private Hospital, South Brisbane, Qld 4101, Australia
John Bashford: The Wesley Hospital, Auchenflower, Brisbane, Qld 4066, Australia
Christobel Saunders: Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA 6009, Australia
Sandra C. Hayes: Menzies Health Institute Qld, Griffith University, Nathan, Brisbane, Qld 4111, Australia

IJERPH, 2020, vol. 17, issue 22, 1-13

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: cost-utility analysis; cost-effectiveness analysis; exercise; breast cancer (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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