Cost-effectiveness analysis of an 18-week exercise programme for patients with breast and colon cancer undergoing adjuvant chemotherapy: The randomised PACT study

Anne M. May, Marcel J.C. Bosch, Miranda J. Velthuis, Elsken Van Der Wall, Charlotte N.Steins Bisschop, Maartje Los, Frans Erdkamp, Haiko J. Bloemendal, Marnix A.J. De Roos, Marlies Verhaar, Daan Ten Bokkel Huinink, Petra H.M. Peeters, G. Ardine De Wit

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Meta-analyses show that exercise interventions during cancer treatment reduce cancerrelated fatigue. However, little is known about the costeffectiveness of such interventions. Here we aim to assess the cost-effectiveness of the 18-week physical activity during cancer treatment (PACT) intervention for patients with breast and colon cancer. The PACT trial showed beneficial effects for fatigue and physical fitness. Design: Cost-effectiveness analyses with a 9-month time horizon (18 weeks of intervention and 18 weeks of follow-up) within the randomised controlled multicentre PACT study. Setting: Outpatient clinics of 7 hospitals in the Netherlands (1 academic and 6 general hospitals) Participants: 204 patients with breast cancer and 33 with colon cancer undergoing adjuvant treatment including chemotherapy. Intervention: Supervised 1-hour aerobic and resistance exercise (twice per week for 18 weeks) or usual care. Main outcome measures: Costs, quality-adjustedlife years (QALY) and the incremental costeffectiveness ratio. Results: For colon cancer, the cost-effectiveness analysis showed beneficial effects of the exercise intervention with incremental costs savings of 4321 and QALY improvements of 0.03. 100% of bootstrap simulations indicated that the intervention is dominant (ie, cheaper and more effective). For breast cancer, the results did not indicate that the exercise intervention was cost-effective. Incremental costs were 2912, and the incremental effect was 0.01 QALY. At a Dutch threshold value of 20 000 per QALY, the probability that the intervention is cost-effective was 2%. Conclusions: Our results suggest that the 18-week exercise programme was cost-effective for colon cancer, but not for breast cancer.

Original languageEnglish (US)
Article numbere012187
JournalBMJ open
Volume7
Issue number3
DOIs
StatePublished - Mar 1 2017

ASJC Scopus subject areas

  • Medicine(all)

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