Cost-effectiveness of a web-based peer-delivered physical activity program for breast cancer survivors

Breast cancer survivors are increasing in number and living longer but often experience reduced quality of life (QOL) from treatment sequelae. Physical activity (PA) interventions can improve QOL, but many rely on costly specialists or are difficult to scale. We adapted an evidence-based peer-mentoring program (moving forward together) for web delivery (webMFT). The platform centralizes peer-coach matching, delivery, and coordination to reduce administrative burden and improve scalability.

We evaluated webMFT's cost-effectiveness.

In a 12-week randomized trial (N = 61), survivors were assigned to webMFT (n = 30; weekly phone calls plus activity self-monitoring) or MVPA Tracking (n = 31; activity self-monitoring only). From a payer's perspective, we estimated incremental cost-effectiveness ratios (ICERs) for quality-adjusted life years (QALYs) and device-measured moderate-to-vigorous physical activity (MVPA). Intervention costs were collected from time logs for research staff and peer coaches. We conducted sensitivity analyses by bootstrapping and constructing cost-effectiveness planes and cost-effectiveness acceptability curves (CEACs).

In the base-case analysis the ICER for webMFT was $38 430 per QALY gained versus MVPA Tracking. At the high end of probabilistic implementation-cost sensitivity analyses that considered wider ranges of wages, platform costs, and implementation times, the mean ICER was $43 418 per QALY and the probability of cost-effectiveness was 87% at the commonly used $150 000 per QALY threshold. WebMFT increased QALYs but did not produce greater increases in device-measured PA compared with MVPA Tracking.

At a $150 000 per QALY threshold, webMFT appears cost-effective for improving QALYs among breast cancer survivors. Larger studies are needed to confirm these findings.

This underlying clinical trial was registered at clinicaltrials.gov (NCT05409664).