A Model-Based Cost-Effectiveness Analysis of an Exercise Program for Lung Cancer Survivors Following Curative-Intent Treatment

摘要: Rationale: The Institute of Medicine emphasizes care in the post-treatment phase cancer survivorship continuum. Physical exercise has been shown to be effective improving physical function and quality life survivors; however, its cost-effectiveness lung survivors is not well established. Objective: We performed a model-based analysis an intervention following curative-intent treatment. Methods: constructed Markov model simulate impact Lifestyle Interventions Independence for Elders (LIFE) compared usual stage I-IIIA survivors. Costs utility benefit were extracted from LIFE study. Baseline utilities, transition probabilities, survival modeled. calculated considered incremental ratios (ICERs) <$100,000/quality-adjusted life-year (QALY) as cost-effective, assessed uncertainty using one-way probabilistic sensitivity analyses. Results: Our base-case found that program would increase overall cost by $4,740 effectiveness 0.06 QALYs care, have ICER $79,504/QALY. was most sensitive program, probability increasing exercise, related exercise. At willingness-to-pay threshold $100,000/QALY, had 71% being cost-effective 27% care. When we included opportunity costs, $179,774/QALY, exceeding threshold. Conclusions: A simulation treatment demonstrates organization but societal perspective. Strategies effectively remotely may more than in-facility strategies these patients.