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Breast Cancer Research and Treatment

, Volume 94, Issue 2, pp 123–133 | Cite as

A Cost-effectiveness Analysis of Two Rehabilitation Support Services for Women with Breast Cancer

  • Louisa G. GordonEmail author
  • Paul Scuffham
  • Diana Battistutta
  • Nick Graves
  • Margaret Tweeddale
  • Beth Newman
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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.

Keywords

breast cancer cost-effectiveness quality of life rehabilitation upper-body function 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Louisa G. Gordon
    • 1
    • 4
    Email author
  • Paul Scuffham
    • 2
  • Diana Battistutta
    • 1
  • Nick Graves
    • 1
  • Margaret Tweeddale
    • 3
  • Beth Newman
    • 1
  1. 1.Centre for Health Research School of Public HealthQueensland University of TechnologyBrisbaneAustralia
  2. 2.School of Population HealthUniversity of QueenslandBrisbaneAustralia
  3. 3.Domiciliary and Allied Health Acute Care Rehabilitation TeamSouth BrisbaneAustralia
  4. 4.Queensland Cancer FundBrisbaneAustralia

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