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

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 b...

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Autores principales: Gordon, Louisa G., Eakin, Elizabeth G., Spence, Rosalind R., Pyke, Christopher, Bashford, John, Saunders, Christobel, Hayes, Sandra C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699530/
https://www.ncbi.nlm.nih.gov/pubmed/33228174
http://dx.doi.org/10.3390/ijerph17228608
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author Gordon, Louisa G.
Eakin, Elizabeth G.
Spence, Rosalind R.
Pyke, Christopher
Bashford, John
Saunders, Christobel
Hayes, Sandra C.
author_facet Gordon, Louisa G.
Eakin, Elizabeth G.
Spence, Rosalind R.
Pyke, Christopher
Bashford, John
Saunders, Christobel
Hayes, Sandra C.
author_sort Gordon, Louisa G.
collection PubMed
description 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.
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spelling pubmed-76995302020-11-29 Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up Gordon, Louisa G. Eakin, Elizabeth G. Spence, Rosalind R. Pyke, Christopher Bashford, John Saunders, Christobel Hayes, Sandra C. Int J Environ Res Public Health Article 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. MDPI 2020-11-19 2020-11 /pmc/articles/PMC7699530/ /pubmed/33228174 http://dx.doi.org/10.3390/ijerph17228608 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gordon, Louisa G.
Eakin, Elizabeth G.
Spence, Rosalind R.
Pyke, Christopher
Bashford, John
Saunders, Christobel
Hayes, Sandra C.
Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title_full Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title_fullStr Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title_full_unstemmed Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title_short Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up
title_sort cost-effectiveness analysis from a randomized controlled trial of tailored exercise prescription for women with breast cancer with 8-year follow-up
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699530/
https://www.ncbi.nlm.nih.gov/pubmed/33228174
http://dx.doi.org/10.3390/ijerph17228608
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