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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

Author

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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
    School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, Brisbane, Qld 4059, Australia
    Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Brisbane, Qld 4006, 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)

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.

Suggested Citation

  • Louisa G. Gordon & Elizabeth G. Eakin & Rosalind R. Spence & Christopher Pyke & John Bashford & Christobel Saunders & Sandra C. Hayes, 2020. "Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up," IJERPH, MDPI, vol. 17(22), pages 1-13, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8608-:d:447827
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    References listed on IDEAS

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    4. Michael Gmeinder & David Morgan & Michael Mueller, 2017. "How much do OECD countries spend on prevention?," OECD Health Working Papers 101, OECD Publishing.
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