While there is good evidence that exercise is an effective adjunct therapy to cancer care, little is known about its value for money. The aim of this systematic review is to explore the available evidence pertaining to the cost-effectiveness of exercise interventions following cancer. A search of eight online databases (CINAHL, the Cochrane Library (NHSEED), Econlit, Embase, PsycInfo, PubMed, Scopus, Web of science) was first conducted on 26 March 2021 and updated on 8 March 2022. Only economic evaluations with results in the form of incremental cost-effectiveness ratio (ICER) were included. The Consolidated Health Economics Evaluation Reporting Standards (CHEERS) was used to appraise the quality of reporting in the studies. The study protocol was registered in PROSPERO. Sixteen studies comprising seven (44%) cost-utility analyses (CUA), one (6%) cost-effectiveness analyses (CEA) and eight (50%) combined CUA and CEA were identified. These studies explored exercise in five cancer types (breast, colon, lung, prostate, and blood), with half (50%) in breast cancer. Seven studies (44%) adopted societal perspectives. Exercise interventions were found to be cost-effective in five of ten (50%) trial-based economic evaluations and in five of the six (83%) model-based economic evaluations. Most exercise interventions included were supervised, while close supervision and individualized exercise sessions incurred higher costs. Exercise interventions in cancer care are cost-effective for various cancer types despite considerable heterogeneity in exercise delivery and the type of analysis used for economic evaluation. There is clear value in using decision-analytic modelling to account for the long-term benefits of exercise in cancer care.
Preventive medicine. 2023 Mar 23 [Epub]
Yufan Wang, Alexandra L McCarthy, Sandra C Hayes, Louisa G Gordon, Vivian Chiu, Tom G Bailey, Elizabeth Stewart, Haitham Tuffaha
School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia; Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia. Electronic address: ., School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia; Mater Research Institute, Brisbane, QLD, Australia., School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, QLD, Australia., Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology (QUT), QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia., School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia; School of Psychology, The University of Queensland, Brisbane, QLD, Australia; National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia., School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia., School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia., Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia.