title: Cost-effectiveness of a pragmatic exercise intervention for women with breast cancer: results from a randomized controlled trial.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.|Menzies Health Institute Queensland, Centre for Applied Health Economics, Griffith University, Meadowbrook, Queensland, Australia.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Gordon
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.|Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: DiSipio
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Battistutta
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.|School of Nursing and Midwifery, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Patsy
authors.initials: P
authors.lastname: Yates
authors.affiliation: The Wesley Hospital, Auchenflower, Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Bashford
authors.affiliation: Department of Surgery, Mater Hospital, University of Queensland, St Lucia, Queensland, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Pyke
authors.affiliation: Cancer Prevention Research Centre, School of Population Health, University of Queensland, Herston, Queensland, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Eakin
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.|Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000191:economics* / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D015444:Exercise; D005081:Exercise Therapy / Q000191:economics*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome
keywords: breast cancer; cost-effectiveness; exercise intervention; oncology; quality-adjusted life years