Cost-effectiveness of a pragmatic exercise intervention for women with breast cancer: results from a randomized controlled trial
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Author(s)
Gordon, Louisa G
DiSipio, Tracey
Battistutta, Diana
Yates, Patsy
Bashford, John
Pyke, Chris
Eakin, Elizabeth
Hayes, Sandra C
Griffith University Author(s)
Year published
2017
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Show full item recordAbstract
Objective: To report on the cost‐effectiveness of the Exercise for Health trial, comparing an
exercise intervention with usual care during and following treatment for women with breast
cancer.
Methods: Women with breast cancer were randomized to an 8‐month exercise intervention
(involving regular contact with an exercise physiologist over the phone, n = 67, or home delivered
face to face, n = 67) or usual care (n = 60) group and were assessed pre‐intervention
(5 weeks post‐surgery), mid‐intervention (6 months post‐surgery), and 10 weeks post‐intervention
(12 months post‐surgery). The benefit measures were “number of improvers” ...
View more >Objective: To report on the cost‐effectiveness of the Exercise for Health trial, comparing an exercise intervention with usual care during and following treatment for women with breast cancer. Methods: Women with breast cancer were randomized to an 8‐month exercise intervention (involving regular contact with an exercise physiologist over the phone, n = 67, or home delivered face to face, n = 67) or usual care (n = 60) group and were assessed pre‐intervention (5 weeks post‐surgery), mid‐intervention (6 months post‐surgery), and 10 weeks post‐intervention (12 months post‐surgery). The benefit measures were “number of improvers” in quality of life (FACT‐B+4) and quality‐adjusted life years (QALYs). Data on provider, patient, and government costs were used to consider 2 cost scenarios: (1) a service provider model and (2) a private model. Results: There were 69 improvers in the intervention group compared with 21 in the usual care group (odds ratio 2.09, 95% confidence interval 1.08, 4.01; P = .033). The incremental cost per improver was A$2282 to A$2644. Quality‐adjusted life years gain for the intervention group versus the usual care group was 0.009, with incremental cost per QALY gain for models 1 and 2 being A$105 231 and A$90 842, respectively. However, sensitivity analyses indicate that incremental cost per QALY gained was volatile to EuroQol‐5D‐3L weights. Conclusions: Findings suggest that a pragmatic exercise intervention yields more women with markedly improved quality of life after breast cancer than usual care and may be cost‐effective. The results are less certain in terms of incremental cost per quality‐adjusted life years; however, this may be an inappropriate measure for reflecting exercise benefit for women with breast cancer.
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View more >Objective: To report on the cost‐effectiveness of the Exercise for Health trial, comparing an exercise intervention with usual care during and following treatment for women with breast cancer. Methods: Women with breast cancer were randomized to an 8‐month exercise intervention (involving regular contact with an exercise physiologist over the phone, n = 67, or home delivered face to face, n = 67) or usual care (n = 60) group and were assessed pre‐intervention (5 weeks post‐surgery), mid‐intervention (6 months post‐surgery), and 10 weeks post‐intervention (12 months post‐surgery). The benefit measures were “number of improvers” in quality of life (FACT‐B+4) and quality‐adjusted life years (QALYs). Data on provider, patient, and government costs were used to consider 2 cost scenarios: (1) a service provider model and (2) a private model. Results: There were 69 improvers in the intervention group compared with 21 in the usual care group (odds ratio 2.09, 95% confidence interval 1.08, 4.01; P = .033). The incremental cost per improver was A$2282 to A$2644. Quality‐adjusted life years gain for the intervention group versus the usual care group was 0.009, with incremental cost per QALY gain for models 1 and 2 being A$105 231 and A$90 842, respectively. However, sensitivity analyses indicate that incremental cost per QALY gained was volatile to EuroQol‐5D‐3L weights. Conclusions: Findings suggest that a pragmatic exercise intervention yields more women with markedly improved quality of life after breast cancer than usual care and may be cost‐effective. The results are less certain in terms of incremental cost per quality‐adjusted life years; however, this may be an inappropriate measure for reflecting exercise benefit for women with breast cancer.
View less >
Journal Title
Psycho-Oncology
Copyright Statement
© 2016 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Cost‐effectiveness of a pragmatic exercise intervention for women with breast cancer: results from a randomized controlled trial, Psycho-Oncology, Volume 26, Issue 5, Pages 649-655, 2017, which has been published in final form at https://doi.org/10.1002/pon.4201. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
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This publication has been entered into Griffith Research Online as an Advanced Online Version.
Subject
Oncology and carcinogenesis not elsewhere classified
Health services and systems not elsewhere classified
Allied health and rehabilitation science not elsewhere classified
Biomedical and clinical sciences
Psychology