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@ARTICLE{Schouten:296217,
      author       = {A. E. M. Schouten and A. E. Hiensch and G. W. J. Frederix
                      and E. M. Monninkhof and M. Schmidt$^*$ and D. Clauss and N.
                      Gunasekara and J. Belloso and M. Trevaskis and H. Rundqvist
                      and J. Wiskemann$^*$ and J. Müller and M. G. Sweegers and
                      C. Fremd and R. Altena and R. M. Bijlsma and G. Sonke and A.
                      Lahuerta and G. B. Mann and P. A. Francis and G. Richardson
                      and W. Malter and J. Kufel-Grabowska and E. van der Wall and
                      N. K. Aaronson and E. Senkus and A. Urruticoechea and E. M.
                      Zopf and W. Bloch and M. M. Stuiver and Y. Wengstrom and K.
                      Steindorf$^*$ and M. P. van der Meulen and A. M. May},
      title        = {{S}upervised {E}xercise for {P}atients {W}ith {M}etastatic
                      {B}reast {C}ancer: {A} {C}ost-{U}tility {A}nalysis
                      {A}longside the {PREFERABLE}-{EFFECT} {R}andomized
                      {C}ontrolled {T}rial.},
      journal      = {Journal of clinical oncology},
      volume       = {43},
      number       = {11},
      issn         = {0732-183X},
      address      = {Alexandria, Va.},
      publisher    = {American Society of Clinical Oncology},
      reportid     = {DKFZ-2025-00130},
      pages        = {1325-1336},
      year         = {2025},
      note         = {2025 Apr 10;43(11):1325-1336},
      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.},
      cin          = {C110 / D120},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331 / I:(DE-He78)D120-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39805062},
      doi          = {10.1200/JCO-24-01441},
      url          = {https://inrepo02.dkfz.de/record/296217},
}