Cost-effectiveness of an exercise and nutritional intervention versus usual nutritional care during adjuvant treatment for localized breast cancer: the PASAPAS randomized controlled trial

We undertook a cost-effectiveness analysis (CEA) to compare an exercise and nutritional program with the usual nutritional care concomitant to adjuvant chemotherapy in localized breast cancer patients. The CEA was designed as part of the interventional, controlled, randomized, single-center, open-la...

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Published in:Supportive care in cancer 2020-06, Vol.28 (6), p.2829-2842
Main Authors: Perrier, Lionel, Foucaut, Aude-Marie, Morelle, Magali, Touillaud, Marina, Kempf-Lépine, Anne-Sophie, Heinz, Dominik, Gomez, Frédéric, Meyrand, Renaud, Baudinet, Cédric, Berthouze, Sophie, Reynes, Eric, Carretier, Julien, Guillemaut, Séverine, Pérol, David, Trédan, Olivier, Philip, Thierry, Bachmann, Patrick, Fervers, Béatrice
Format: Article
Language:English
Subjects:
Adjuvant treatment
Analysis
Breast cancer
Cancer
Chemotherapy
Clinical trials
Cost analysis
Cost benefit analysis
Economic aspects
Economics and Finance
Exercise
Humanities and Social Sciences
Medicine
Medicine & Public Health
Nursing
Nursing Research
Oncology
Oncology, Experimental
Original Article
Pain Medicine
Physical fitness
Rehabilitation Medicine
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Summary:We undertook a cost-effectiveness analysis (CEA) to compare an exercise and nutritional program with the usual nutritional care concomitant to adjuvant chemotherapy in localized breast cancer patients. The CEA was designed as part of the interventional, controlled, randomized, single-center, open-label PASAPAS study. Breast cancer patients receiving first-line adjuvant chemotherapy at a French Comprehensive Cancer Center were randomized 2:1 to a 6-month exercise program of supervised indoor and outdoor group sessions in addition to usual nutritional care (exercise arm) or a usual nutritional care group receiving dietary and physical activity counseling (control arm). Costs were assessed from the French national insurance perspective (in Euros, 2012). Incremental cost-effectiveness ratios (ICERs) were calculated for four criteria: body mass index, waist circumference, body fat percentage, and estimated aerobic capacity. Uncertainty around the ICERs was captured by a probabilistic analysis using a non-parametric bootstrap method. The analysis was based on 60 patients enrolled between 2011 and 2013. Average intervention costs per participant were €412 in the exercise arm ( n = 41) and €117 ( n = 19) in the control arm. Total mean costs were €17,344 (standard deviation 9,928) and €20,615 (standard deviation 14,904), respectively, did not differ significantly ( p = 0.51). The 6-month exercise program was deemed to be cost-effective compared with usual care for the estimated aerobic capacity. Multicenter randomized studies with long-term costs and outcomes should be done to provide additional evidence. Clinical trial: The PASAPAS study is registered under ClinicalTrials.gov. Trial registration ID: NCT01331772.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-019-05078-4