Supervised exercise for patients with metastatic breast cancer: a cost-utility analysis alongside the PREFERABLE-EFFECT randomized controlled trial
PURPOSE: To evaluate the cost utility of a 9-month supervised exercise program for patients with metastatic breast cancer (mBC), compared with control (usual care, supplemented with general activity advice and an activity tracker). Evidence on the cost-effectiveness of exercise for patients with mBC...
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| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Article (Journal) |
| Lenguaje: | inglés |
| Publicado: |
January 13, 2025
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| In: |
Journal of clinical oncology
Year: 2025, Volumen: 43, Número: 11, Pages: 1325-1337 |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO-24-01441 |
| Acceso en línea: | Verlag, kostenfrei, Volltext: https://doi.org/10.1200/JCO-24-01441 Verlag, kostenfrei, Volltext: https://ascopubs.org/doi/pdfdirect/10.1200/JCO-24-01441 
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| Notas de Autor: | Aniek E.M. Schouten, Anouk E. Hiensch, Geert W.J. Frederix, Evelyn M. Monninkhof, Martina E. Schmidt, Dorothea Clauss, Nadira Gunasekara, Jon Belloso, Mark Trevaskis, Helene Rundqvist, Joachim Wiskemann, Jana Mueller, Maike G. Sweegers, Carlo Fremd, Renske Altena, Rhode M. Bijlsma, Gabe Sonke, Ainhara Lahuerta, G. Bruce Mann, Prudence A. Francis, Gary Richardson, Wolfram Malter, Joanna Kufel-Grabowska, Elsken van der Wall, Neil K. Aaronson, Elzbieta Senkus, Ander Urruticoechea, Eva M. Zopf, Wilhelm Bloch, Martijn M. Stuiver, Yvonne Wengstrom, Karen Steindorf, Miriam P. van der Meulen, and Anne M. May |
| Sumario: | PURPOSE: To evaluate the cost utility of a 9-month supervised exercise program for patients with metastatic breast cancer (mBC), compared with control (usual care, supplemented with general activity advice and an activity tracker). Evidence on the cost-effectiveness of exercise for patients with mBC is essential for implementation in clinical practice and is currently lacking.METHODSA cost-utility analysis was performed alongside the multinational PREFERABLE-EFFECT randomized controlled trial, conducted in 8 centers across Europe and Australia. Patients with mBC (N = 357) were randomly assigned to either a 9-month, twice-weekly, supervised exercise group (EG) or control group (CG). Costs of the exercise program were calculated through a bottom-up approach. Other health care resource use, productivity losses, and quality of life were collected using country-adapted, self-reported questionnaires. Analyses were conducted from a societal perspective with a time horizon of 9 months. Costs were collected and reported in 2021 Euros (Euro 1 = $1.18 US dollars).RESULTSCompared with the CG, EG resulted in a quality-adjusted life-year (QALY) gain of 0.013 (95% CI, -0.02 to 0.05) over a 9-month period. The mean costs of the exercise program were <euro>1,696 per patient with one-on-one supervision (scenario 1) and <euro>609 with one-on-four supervision (scenario 2). These costs were offset by savings in health care and productivity costs, resulting in mean total cost differences of -<euro>163 (scenario 1) and Euro 1,249 (scenario 2) in favor of EG. The probability of supervised exercise being cost-effective was 65% in scenario 1 and 91% in scenario 2 at a willingness-to-pay threshold of Euro 20,000 per QALY.CONCLUSION: Exercise for patients with mBC increases quality of life, decreases costs, and is likely to be cost-effective. Group-based supervision is expected to have even higher cost-savings. Our positive findings can inform reimbursement of supervised exercise interventions for patients with mBC. |
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| Notas: | Veröffentlicht: 13. Januar 2025 Gesehen am 01.06.2026 |
| Descripción Física: | Online Resource |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO-24-01441 |