A Cost-Effectiveness Analysis of a 6-Month Physical Activity Program Versus Usual Dietary Care During Adjuvant Chemotherapy in Breast Cancer Patients

Objectives The increasing evidence of the clinical benefits from physical activity in cancer patients necessitates the economic assessment of such programs. We undertook a cost-effectiveness analysis to compare a physical activity program and dietary advice versus dietary advice during adjuvant chemotherapy in breast cancer. Methods The CEA was designed as part of an interventional, controlled, randomized, single-centre, open-label, parallel-group study. Breast cancer patients receiving first-line adjuvant chemotherapy at French Comprehensive Cancer Centre were randomized into two arms for our clinical trial: one 6-month supervised physical activity program of indoor and outdoor group sessions in addition to the usual dietary advice (PA arm) and dietary advice only (DA arm). Costs were assessed from the French national insurance perspective (in Euros, 2012). Incremental Cost-Effectiveness Ratios (ICERs) were calculated for the major trial endpoints: Body mass index (BMI), body fat percentage, waist circumference, estimated aerobic capacity (VO2max, mL/min/kg), activity profile (≥3 Metabolic Equivalents of Task [METs] and ≥4 METs). Uncertainty around the ICER was captured by a probabilistic analysis using a non-parametric bootstrap method. Results The analysis was based on 60 patients enrolled between July 2011 and June 2013. The mean cost per patient of the 6-month supervised physical activity program and dietary advice reached €412 (SD: €151; 95% CI €365–459). The mean total costs were €15,776 (SD 9,772) in the PA arm (n = 41) and €18,475 (SD 14,612) in the DA arm (n = 19). PA arm strictly dominated DA arm systematically. Conclusions On the basis of both cost and effectiveness, the study finds potential advantages in using 6-month supervised physical activity program in addition to the usual dietetic care instead of one dietetic care only.