Background: Recent evidence underscores the potential of exercise to mitigate the risk of treatment-related chronic diseases in adult cancer survivors. Integrating supervised exercise training as standard care could yield significant personal health benefits and cost savings to the healthcare system. However, the slow adoption of exercise in cancer rehabilitation persists as a concern.
Objective: This paper assesses the cost-effectiveness, Value of Information (VOI), and Value of Implementation (VOIMP) of an exercise program designed for women with early-stage endometrial cancer in the Australian healthcare context.
Method: A Markov cohort model, informed by literature and structured expert elicitation (SEE), was used to evaluate the cost-effectiveness of a 12-week exercise intervention in women treated for early-stage (I-II) endometrial cancer. National level uptake rates of the program obtained from the SEE were integrated as model parameters. A VOI framework was used to estimate the potential value of further research for the exercise program and the value for money of subsequent implementation decision.
Results: Over five years, compared to standard care , women who adhered to the exercise program had an average incremental cost of $52.38 (95%CI: -197.52, 4022.46) and 0.0209 incremental QALYs (95%CI: 0.0106, 0.0328). This resulted in an incremental cost-effectiveness ratio (ICER) of $2,854.37 (95%CI: -10339.23, 24297.35) at a willingness-to-pay (WTP) threshold of AUD $50,000 per QALY and a target population of 22,899 women over five years, the estimated population-level expected value of perfect information (EVPI) was only AUD $9,846.83. The expected value of perfect implementation (EVPIM) was approximately $96 million.
Conclusion: Supervised exercise interventions for women with endometrial cancer have been demonstrated to be cost-effective. Further research in this area offers limited additional value, whereas optimising the implementation of these exercise programs presents a significant opportunity. Therefore, resources should be prioritised toward enhancing the integration of exercise programs for this patient population.