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A Model-Based Cost-Effectiveness Analysis of an Exercise Program for Lung Cancer Survivors After Curative-Intent
Duc Ha1, Jacqueline Kerr, Andrew L Ries
1From the Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (DH); Division of Behavioral Medicine, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California (JK); Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California (DH, ALR, MMF); Section of Pulmonary and Critical Care Medicine, VA San Diego Healthcare System, San Diego, California (MMF); Moores Cancer Center, University of California San Diego, La Jolla, California (SML); and Gastrointestinal and Palliative Radiation Oncology, Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (JDM).
An exercise intervention for lung cancer survivors is cost-effective from an organizational viewpoint, but not a societal one. Further research into similar programs is warranted for potential cost-effectiveness.
Area of Science:
- Oncology
- Health Economics
- Rehabilitation
Background:
- The cost-effectiveness of exercise interventions for lung cancer survivors remains largely unexamined.
- Lung cancer survivors often experience reduced quality of life and functional capacity post-treatment.
Purpose of the Study:
- To evaluate the cost-effectiveness of the Lifestyle Interventions and Independence for Elders (LIFE) exercise program in lung cancer survivors.
- To compare the LIFE program against usual care using a Markov model.
Main Methods:
- A model-based cost-effectiveness analysis was conducted using Markov modeling.
- The analysis simulated the impact of the LIFE exercise intervention versus usual care for stage I-IIIA lung cancer survivors post-treatment.
- Sensitivity analyses were performed to assess model uncertainty, with a willingness-to-pay threshold of $100,000/quality-adjusted life-year.
Main Results:
- The LIFE program demonstrated an incremental cost-effectiveness ratio (ICER) of $79,504/quality-adjusted life-year, increasing costs by $4740 and effectiveness by 0.06 quality-adjusted life-years compared to usual care.
- The model indicated a 71% probability of the LIFE program being cost-effective at the $100,000/quality-adjusted life-year threshold from an organizational perspective.
- However, when opportunity costs were included, the ICER rose to $179,774/quality-adjusted life-year, exceeding the cost-effectiveness threshold.
Conclusions:
- The LIFE exercise intervention is cost-effective from an organizational perspective but not from a societal perspective for lung cancer survivors.
- The findings suggest that similar exercise programs may hold potential for cost-effectiveness in this population.
- Further investigation into the societal economic impact and long-term benefits of exercise interventions for cancer survivors is recommended.
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