Supervised Exercise for Patients With Metastatic Breast Cancer: A Cost-Utility Analysis Alongside the PREFERABLE-EFFECT Randomized Controlled Trial Article Swipe

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Aniek E.M. Schouten , Anouk E. Hiensch , Geert Frederix , Evelyn M. Monninkhof , Martina E. Schmidt , Dorothea Clauss , Nadira Gunasekara , Jon Belloso , Mark Trevaskis , Helene Rundqvist , Joachim Wiskemann , J.H. Müller , Maike G. Sweegers , Carlo Fremd , Renske Altena , Rhodé M. Bijlsma , Gabe S. Sonke , Ainhara Lahuerta , G. Bruce Mann , Prudence A. Francis , Gary Richardson , Wolfram Malter , Joanna Kufel-Grabowska , Elsken van der Wall , Neil K. Aaronson , Elżbieta Senkus , Ander Urruticoechea , Eva M. Zopf , Wilhelm Bloch , Martijn M. Stuiver , Yvonne Wengström , Karen Steindorf , Miriam P. van der Meulen , Anne M. May ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1200/jco-24-01441

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.

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Medicine

Randomized Controlled Trial

Concepts

Medicine Randomized controlled trial Physical therapy Cost effectiveness Quality of life (healthcare) Metastatic breast cancer Breast cancer Quality-adjusted life year Cost-effectiveness analysis Cost–benefit analysis Cancer Surgery Internal medicine Nursing Biology Ecology Risk analysis (engineering)

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Type: article
Language: en
Landing Page: https://doi.org/10.1200/jco-24-01441
OA Status: green
Cited By: 3
References: 44
Related Works: 10
OpenAlex ID: https://openalex.org/W4406312661

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OpenAlex ID: https://openalex.org/W4406312661

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DOI: https://doi.org/10.1200/jco-24-01441

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Title: Supervised Exercise for Patients With Metastatic Breast Cancer: A Cost-Utility Analysis Alongside the PREFERABLE-EFFECT Randomized Controlled Trial

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Type: article

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Language: en

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Publication year: 2025

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Publication date: 2025-01-13

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Authors: Aniek E.M. Schouten, Anouk E. Hiensch, Geert Frederix, Evelyn M. Monninkhof, Martina E. Schmidt, Dorothea Clauss, Nadira Gunasekara, Jon Belloso, Mark Trevaskis, Helene Rundqvist, Joachim Wiskemann, J.H. Müller, Maike G. Sweegers, Carlo Fremd, Renske Altena, Rhodé M. Bijlsma, Gabe S. Sonke, Ainhara Lahuerta, G. Bruce Mann, Prudence A. Francis, Gary Richardson, Wolfram Malter, Joanna Kufel-Grabowska, Elsken van der Wall, Neil K. Aaronson, Elżbieta Senkus, Ander Urruticoechea, Eva M. Zopf, Wilhelm Bloch, Martijn M. Stuiver, Yvonne Wengström, Karen Steindorf, Miriam P. van der Meulen, Anne M. May

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Landing page: https://doi.org/10.1200/jco-24-01441

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OA URL: https://www.ncbi.nlm.nih.gov/pmc/articles/11974635

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Concepts: Medicine, Randomized controlled trial, Physical therapy, Cost effectiveness, Quality of life (healthcare), Metastatic breast cancer, Breast cancer, Quality-adjusted life year, Cost-effectiveness analysis, Cost–benefit analysis, Cancer, Surgery, Internal medicine, Nursing, Biology, Ecology, Risk analysis (engineering)

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Cited by: 3

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Citations by year (recent): 2025: 3

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References (count): 44

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