IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i22p8608-d447827.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/22/8608/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/22/8608/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Michael Gmeinder & David Morgan & Michael Mueller, 2017. "How much do OECD countries spend on prevention?," OECD Health Working Papers 101, OECD Publishing.
    2. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    3. Rachael Fleurence & Christopher Hollenbeak, 2007. "Rates and Probabilities in Economic Modelling," PharmacoEconomics, Springer, vol. 25(1), pages 3-6, January.
    4. Lionel Perrier & Aude-Marie Foucaut & Magali Morelle & Marina S. Touillaud & Anne-Sophie Kempf-Lépine & Dominik Heinz & Frédéric Gomez & Renaud Meyrand & Cédric Baudinet & Sophie Berthouze & Eric Reyn, 2020. "Cost-effectiveness of an exercise and nutritional intervention versus usual nutritional care during adjuvant treatment for localized breast cancer: the PASAPAS randomized controlled trial," Post-Print halshs-02378666, HAL.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Louisa G. Gordon & William Leung & Richard Johns & Bronwen McNoe & Daniel Lindsay & Katharina M. D. Merollini & Thomas M. Elliott & Rachel E. Neale & Catherine M. Olsen & Nirmala Pandeya & David C. Wh, 2022. "Estimated Healthcare Costs of Melanoma and Keratinocyte Skin Cancers in Australia and Aotearoa New Zealand in 2021," IJERPH, MDPI, vol. 19(6), pages 1-14, March.
    2. Giovanna Elisa Calabrò & Sara Boccalini & Donatella Panatto & Caterina Rizzo & Maria Luisa Di Pietro & Fasika Molla Abreha & Marco Ajelli & Daniela Amicizia & Angela Bechini & Irene Giacchetta & Piero, 2022. "The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment," IJERPH, MDPI, vol. 19(7), pages 1-14, March.
    3. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    4. Clarke, Lorcan, 2020. "An introduction to economic studies, health emergencies, and COVID-19," LSE Research Online Documents on Economics 105051, London School of Economics and Political Science, LSE Library.
    5. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.
    6. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    7. Thomas Grochtdreis & Hans-Helmut König & Alexander Dobruschkin & Gunhild von Amsberg & Judith Dams, 2018. "Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-25, December.
    8. Wendy Hens & Dirk Vissers & Nick Verhaeghe & Jan Gielen & Luc Van Gaal & Jan Taeymans, 2021. "Unsupervised Exercise Training Was Not Found to Improve the Metabolic Health or Phenotype over a 6-Month Dietary Intervention: A Randomised Controlled Trial with an Embedded Economic Analysis," IJERPH, MDPI, vol. 18(15), pages 1-13, July.
    9. Kim Edmunds & Penny Reeves & Paul Scuffham & Daniel A. Galvão & Robert U. Newton & Mark Jones & Nigel Spry & Dennis R. Taaffe & David Joseph & Suzanne K. Chambers & Haitham Tuffaha, 2020. "Cost-Effectiveness Analysis of Supervised Exercise Training in Men with Prostate Cancer Previously Treated with Radiation Therapy and Androgen-Deprivation Therapy," Applied Health Economics and Health Policy, Springer, vol. 18(5), pages 727-737, October.
    10. Andrew Gawron & Dustin French & John Pandolfino & Colin Howden, 2014. "Economic Evaluations of Gastroesophageal Reflux Disease Medical Management," PharmacoEconomics, Springer, vol. 32(8), pages 745-758, August.
    11. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    12. Frank G. Sandmann & Julie V. Robotham & Sarah R. Deeny & W. John Edmunds & Mark Jit, 2018. "Estimating the opportunity costs of bed‐days," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 592-605, March.
    13. Jesse Elliott & Sasha Katwyk & Bláthnaid McCoy & Tammy Clifford & Beth K. Potter & Becky Skidmore & George A. Wells & Doug Coyle, 2019. "Decision Models for Assessing the Cost Effectiveness of Treatments for Pediatric Drug-Resistant Epilepsy: A Systematic Review of Economic Evaluations," PharmacoEconomics, Springer, vol. 37(10), pages 1261-1276, October.
    14. Wei Zhang & Aslam Anis, 2014. "Health-Related Productivity Loss: NICE to Recognize Soon, Good to Discuss Now," PharmacoEconomics, Springer, vol. 32(5), pages 425-427, May.
    15. Katherine Edwards & Natasha Jones & Julia Newton & Charlie Foster & Andrew Judge & Kate Jackson & Nigel K. Arden & Rafael Pinedo-Villanueva, 2017. "The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature," Health Economics Review, Springer, vol. 7(1), pages 1-23, December.
    16. Don Husereau & Michael Drummond & Stavros Petrou & Dan Greenberg & Josephine Mauskopf & Federico Augustovski & Andrew Briggs & David Moher & Elizabeth Loder & Chris Carswell, 2015. "Reply to Roberts et al.: CHEERS is Sufficient for Reporting Cost-Benefit Analysis, but May Require Further Elaboration," PharmacoEconomics, Springer, vol. 33(5), pages 535-536, May.
    17. Nina van der Vliet & Anita W.M. Suijkerbuijk & Adriana T. de Blaeij & G. Ardine de Wit & Paul F. van Gils & Brigit A.M. Staatsen & Rob Maas & Johan J. Polder, 2020. "Ranking Preventive Interventions from Different Policy Domains: What Are the Most Cost-Effective Ways to Improve Public Health?," IJERPH, MDPI, vol. 17(6), pages 1-24, March.
    18. Simon van der Schans & Lucas M. A. Goossens & Melinde R. S. Boland & Janwillem W. H. Kocks & Maarten J. Postma & Job F. M. van Boven & Maureen P. M. H. Rutten-van Mölken, 2017. "Systematic Review and Quality Appraisal of Cost-Effectiveness Analyses of Pharmacologic Maintenance Treatment for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Recommendatio," PharmacoEconomics, Springer, vol. 35(1), pages 43-63, January.
    19. Andrew Briggs & Rachel Nugent, 2016. "Editorial," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 6-8, February.
    20. Don Husereau & Michael Drummond & Federico Augustovski & Esther Bekker-Grob & Andrew H. Briggs & Chris Carswell & Lisa Caulley & Nathorn Chaiyakunapruk & Dan Greenberg & Elizabeth Loder & Josephine Ma, 2022. "Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1309-1317, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8608-:d:447827. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.