TY - JOUR
T1 - Supervised Exercise for Patients With Metastatic Breast Cancer
T2 - A Cost-Utility Analysis Alongside the PREFERABLE-EFFECT Randomized Controlled Trial
AU - Schouten, Aniek E M
AU - Hiensch, Anouk E
AU - Frederix, Geert W J
AU - Monninkhof, Evelyn M
AU - Schmidt, Martina E
AU - Clauss, Dorothea
AU - Gunasekara, Nadira
AU - Belloso, Jon
AU - Trevaskis, Mark
AU - Rundqvist, Helene
AU - Wiskemann, Joachim
AU - Müller, Jana
AU - Sweegers, Maike G
AU - Fremd, Carlo
AU - Altena, Renske
AU - Bijlsma, Rhodé M
AU - Sonke, Gabe
AU - Lahuerta, Ainhara
AU - Mann, G Bruce
AU - Francis, Prudence A
AU - Richardson, Gary
AU - Malter, Wolfram
AU - Kufel-Grabowska, Joanna
AU - van der Wall, Elsken
AU - Aaronson, Neil K
AU - Senkus, Elzbieta
AU - Urruticoechea, Ander
AU - Zopf, Eva M
AU - Bloch, Wilhelm
AU - Stuiver, Martijn M
AU - Wengstrom, Yvonne
AU - Steindorf, Karen
AU - van der Meulen, Miriam P
AU - May, Anne M
PY - 2025/1/13
Y1 - 2025/1/13
N2 - 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.METHODS: A 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 (€1 = $1.18 US dollars).RESULTS: Compared 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 €1,696 per patient with one-on-one supervision (scenario 1) and €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 -€163 (scenario 1) and -€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 €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.
AB - 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.METHODS: A 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 (€1 = $1.18 US dollars).RESULTS: Compared 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 €1,696 per patient with one-on-one supervision (scenario 1) and €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 -€163 (scenario 1) and -€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 €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.
U2 - 10.1200/JCO-24-01441
DO - 10.1200/JCO-24-01441
M3 - Journal articles
C2 - 39805062
SN - 0732-183X
SP - JCO2401441
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
ER -
