Journal Article

DKFZ-2025-00130

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Supervised Exercise for Patients With Metastatic Breast Cancer: A Cost-Utility Analysis Alongside the PREFERABLE-EFFECT Randomized Controlled Trial.

Schouten, A. E. M. ; Hiensch, A. E. ; Frederix, G. W. J. ; Monninkhof, E. M. ; Schmidt, M.DKFZ* ; Clauss, D. ; Gunasekara, N. ; Belloso, J. ; Trevaskis, M. ; Rundqvist, H. ; Wiskemann, J.DKFZ* ; Müller, J. ; Sweegers, M. G. ; Fremd, C. ; Altena, R. ; Bijlsma, R. M. ; Sonke, G. ; Lahuerta, A. ; Mann, G. B. ; Francis, P. A. ; Richardson, G. ; Malter, W. ; Kufel-Grabowska, J. ; van der Wall, E. ; Aaronson, N. K. ; Senkus, E. ; Urruticoechea, A. ; Zopf, E. M. ; Bloch, W. ; Stuiver, M. M. ; Wengstrom, Y. ; Steindorf, K.DKFZ* ; van der Meulen, M. P. ; May, A. M.

2025
American Society of Clinical Oncology Alexandria, Va.

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Please use a persistent id in citations: doi:10.1200/JCO-24-01441

Abstract: 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.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).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.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.

Note: 2025 Apr 10;43(11):1325-1336

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Contributing Institute(s):

1. Bewegung, Krebsprävention und Survivorship (C110)
2. Angewandte Tumor-Immunität (D120)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2025

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 40 ; JCR ; Nationallizenz ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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