By: Jeff Minerd
From: medpagetoday.com
A supervised exercise already shown to alleviate fatigue and other side effects in patients with metastatic breast cancer has now been found to also be cost analysis.
Anne May, PhD, of Utrecht University in the Netherlands, and colleagues performed a cost-utility analysis of the 357 patients in the PREFERABLE-EFFECT trial, reported in 2024. Patients were randomly assigned to either a 9-month, twice-weekly supervised exercise program or a control group who received general activity advice and used an activity tracker.
“To date, research has focused primarily on the efficacy and effectiveness of exercise in cancer care, while little is known about its cost-effectiveness,” May and colleagues explained in the Journal of Clinical Oncology.
The costs were collected and reported in 2021 Euros (at that time €1=$1.18 U.S. dollars).
The mean costs of the exercise program were €1,696 (about $2,001) per patient with one-on-one supervision and €609 ($717) with one-on-four supervision. The costs were offset by savings in healthcare and productivity costs, resulting in mean total cost differences of –€163 (–$192) with one-on-one supervision and –€1,249 (–$1,474) with one-on-four supervision.
May discussed additional details and implications in the following interview.
Why did you decide to undertake a cost-effectiveness study?
May: In many countries exercise is not reimbursed by basic health insurance, which negatively affects the accessibility of exercise. Showing that exercise is not only effective but also cost-effective is important information to get exercise reimbursed. That’s why we performed a cost-utility analysis alongside the PREFERABLE-EFFECT trial.
What specific kinds of exercise did patients engage in?
May: Patients followed a 9-month exercise intervention under the supervision of a specialized exercise trainer. The program consisted of endurance, resistance, and balance exercises. These exercises were performed with intensities that fit the patient’s fitness level, and if needed exercises were adapted for patients with bone metastases (dependent on the location of the metastases).
In the first 6 months, the patients attended two exercise sessions a week, and in the last 3 months one supervised session was replaced with one unsupervised session. All information on the exercise program can be found here.
How did you calculate the costs and savings associated with the exercise program?
May: The patients filled in validated questionnaires every 3 months from which we retrieved the information to calculate healthcare costs and non-healthcare costs. Furthermore, for each study center, we calculated the costs of the exercise program. All relevant costs in the exercise group were summed and averaged and compared with the mean costs in the control group.
What were the largest types of cost savings you found?
May: The largest cost savings were found for hospital costs — e.g., we found that patients in the exercise group visited the emergency room less often as compared with the control group. In second place, we found less loss of productivity for working participants of the exercise group. Interestingly, short-term sick leave was less in the exercise group.
Although people with metastatic breast cancer cannot currently be cured of their disease, they can live for many months or years and can still work. So, reducing sick leave is an important finding. It is vital they have the best possible quality of life. Also, we found that exercising in a group is less costly than exercising alone.
What are the main implications of your findings?
May: We were already happy that our trial showed that exercise during the treatment for metastatic breast cancer had positive effects on fatigue and quality of life as well as side effects like pain and dyspnea. That we now can also report that exercising leads to a decrease in healthcare and societal costs and is cost effective further strengthens the recommendation that exercise should be part of standard care for patients with metastatic breast cancer.
Read the study here.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.