A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer

Gordon, Louisa G., Scuffham, Paul, Battistutta, Diana, Graves, Nick, Tweeddale, Margaret and Newman, Beth (2005) A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer. Breast Cancer Research and Treatment, 94 2: 123-133. doi:10.1007/s10549-005-5828-9


Author Gordon, Louisa G.
Scuffham, Paul
Battistutta, Diana
Graves, Nick
Tweeddale, Margaret
Newman, Beth
Title A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer
Journal name Breast Cancer Research and Treatment   Check publisher's open access policy
ISSN 0167-6806
1573-7217
Publication date 2005
Sub-type Article (original research)
DOI 10.1007/s10549-005-5828-9
Volume 94
Issue 2
Start page 123
End page 133
Total pages 11
Editor M. E. Kippman
Place of publication New York, NY, United States
Publisher Springer
Collection year 2005
Language eng
Subject 321202 Epidemiology
730201 Women's health
Abstract The purpose of this research was to estimate the cost-effectiveness of two rehabilitation interventions for breast cancer survivors, each compared to a population-based, non-intervention group (n = 208). The two services included an early home-based physiotherapy intervention (DAART, n = 36) and a group-based exercise and psychosocial intervention (STRETCH, n = 31). A societal perspective was taken and costs were included as those incurred by the health care system, the survivors and community. Health outcomes included: (a) 'rehabilitated cases' based on changes in health-related quality of life between 6 and 12 months post-diagnosis, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity (FACT-B+4) questionnaire, and (b) quality-adjusted life years (QALYs) using utility scores from the Subjective Health Estimation (SHE) scale. Data were collected using self-reported questionnaires, medical records and program budgets. A Monte-Carlo modelling approach was used to test for uncertainty in cost and outcome estimates. The proportion of rehabilitated cases was similar across the three groups. From a societal perspective compared with the non-intervention group, the DAART intervention appeared to be the most efficient option with an incremental cost of $1344 per QALY gained, whereas the incremental cost per QALY gained from the STRETCH program was $14,478. Both DAART and STRETCH are low-cost, low-technological health promoting programs representing excellent public health investments.
Keyword Breast Cancer
Cost-effectiveness
Quality Of Life
Rehabilitation
Upper-body Function
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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