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Cost effectiveness of high versus low-to-moderate intensity exercise during oncological treatment : The Phys-Can RCT

Ax, AK (author)
Linköping University
Husberg, M (author)
Linköping University
Johansson, BB (author)
Uppsala University
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Demmelmaier, I (author)
Uppsala University
Berntsen, S (author)
University of Agder
Sjövall, Katarina (author)
Faculty of Health Science,Man - Health - Society (MHS),Department of Nursing and Integrated Health Sciences,Fakulteten för hälsovetenskap,Människa - Hälsa - Samhälle (MHS),Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap
Börjeson, S (author)
Linköping University
Nordin, K (author)
Uppsala University
Davidson, T (author)
Linköping University
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 (creator_code:org_t)
Elsevier BV, 2022
2022
English 2
In: Annals of Oncology. - : Elsevier BV. - 0923-7534.
  • Conference paper (peer-reviewed)
Abstract Subject headings
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  • Background A cost-effectiveness analysis, considering both costs and health outcomes of interventions, are important for decision-making and implementation in the health care. Exercise during oncological treatment is beneficial for health and have been found to counteract side effects of treatment. The Swedish Phys-Can RCT compared a six-month exercise program combining supervised resistance training and homebased endurance training of high-intensity (HI) versus low-to-moderate intensity (LMI), with or without additional behaviour change support. At post intervention, HI yielded small improvements of fitness and physical fatigue compared with LMI. At 18 months, no differences were found in total costs between the intensities. However, knowledge of the cost effectiveness in exercise interventions with regard to intensity is limited. In this study, we aimed to evaluate the long-term cost-effectiveness of an exercise program at HI versus LMI during oncological treatment. Methods A cost-effectiveness analysis was undertaken from a societal perspective for 18 months. 189 (n=99 HI and n=90 LMI) participants with breast, colorectal, or prostate cancer were included from the Phys-Can RCT. Health outcomes were measured as quality-adjusted life years (QALYs), using EQ-5D-5L at baseline, six months and 18 months. Costs included the exercise intervention, health care utilisation and productivity loss. Results At 18 months, the total cost per participant did not differ significantly between HI (€27,314) and LMI exercise (€29,788). There was no significant difference in health outcome between the intensities. On average HI generated 1.190 (SD = 0.223) QALYs and LMI 1.185 (SD = 0.211) QALYs for 18 months, meaning HI led to an additional 0.005 QALYs. The incremental cost-effectiveness ratio (ICER) indicates that HI was more effective and saved costs compared with LMI. Conclusions The uncertainty around the ICER was large, however our results indicates that HI exercise was cost-effective compared to LMI exercise at longer term since there was lower total costs per QALY gained. Thus, we suggest that exercise with its health benefits may be implemented regardless of intensity.

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