COSA Exercise Guidelines: What is the value of implementation?
Author(s)
Kim Edmunds, PhD1, Yufan Wang, PhD1, David Mizrahi, PhD2, Sandie McCarthy, PhD3, Haitham Tuffaha, BSc, MBA, MSc, PhD1;
1University of Queensland, Centre for the Business and Economics of Health, St Lucia, Australia, 2University of Sydney, Daffodil Centre, Sydney, Australia, 3Griffith University, Griffith Health Group, Gold Coast, Australia
1University of Queensland, Centre for the Business and Economics of Health, St Lucia, Australia, 2University of Sydney, Daffodil Centre, Sydney, Australia, 3Griffith University, Griffith Health Group, Gold Coast, Australia
Presentation Documents
OBJECTIVES: The Clinical Oncology Society of Australia (COSA) position statement on Exercise in Cancer Care requires healthcare professionals (HCPs) to: 1) Discuss the role of exercise in cancer recovery, 2) Recommend following appropriate exercise guidelines, 3) Refer to an Accredited Exercise Physiologist (AEP) or physiotherapist experienced in cancer care. However, <35% of people receive a referral. Less than perfect (100%) implementation = reduced efficiency. The aim of this economic analysis was to determine the value of implementing these guidelines into clinical practice using the Value of Implementation (VOIM) framework.
METHODS: We conducted a rapid review of economic analyses of exercise oncology interventions. Australian modelled economic evaluations of cost-effective exercise interventions were our sample studies (n=3) to test VOIM of COSA guidelines. We used the Net Monetary Benefit (NMB), incidence of relevant oncology patients, adherence to guidelines by HCPs and patients and cost of implementation strategies to conduct VOIM analysis. The difference between perfect and current implementation (EVPIM) is the available amount to fund improvement in implementation.
RESULTS: For one study (Edmunds et al. 2022), EVPIM was $159,035,777. A HCP education strategy cost of $5,000,000 to improve uptake by 15% with net benefit of $13,000,000. A patient motivation strategy cost of $25,000,000 to improve uptake by 35% with net benefit of $18,000,000. Both were cost effective to implement but the patient program delivered better value for money.
CONCLUSIONS: While there were limitations associated with this study (lack of Australian studies; heterogeneity, adherence based on expert opinion; assumption of immediate rather than dynamic uptake post implementation strategy), this VOIM analysis demonstrates the value of guidelines in implementing exercise oncology and the potential cost-effectiveness of implementation strategies in improving adherence and efficiency. VOIM analysis can assist HCPs in deciding which strategy to implement and decision makers in which interventions to fund to achieve best value for money.
METHODS: We conducted a rapid review of economic analyses of exercise oncology interventions. Australian modelled economic evaluations of cost-effective exercise interventions were our sample studies (n=3) to test VOIM of COSA guidelines. We used the Net Monetary Benefit (NMB), incidence of relevant oncology patients, adherence to guidelines by HCPs and patients and cost of implementation strategies to conduct VOIM analysis. The difference between perfect and current implementation (EVPIM) is the available amount to fund improvement in implementation.
RESULTS: For one study (Edmunds et al. 2022), EVPIM was $159,035,777. A HCP education strategy cost of $5,000,000 to improve uptake by 15% with net benefit of $13,000,000. A patient motivation strategy cost of $25,000,000 to improve uptake by 35% with net benefit of $18,000,000. Both were cost effective to implement but the patient program delivered better value for money.
CONCLUSIONS: While there were limitations associated with this study (lack of Australian studies; heterogeneity, adherence based on expert opinion; assumption of immediate rather than dynamic uptake post implementation strategy), this VOIM analysis demonstrates the value of guidelines in implementing exercise oncology and the potential cost-effectiveness of implementation strategies in improving adherence and efficiency. VOIM analysis can assist HCPs in deciding which strategy to implement and decision makers in which interventions to fund to achieve best value for money.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE161
Topic
Economic Evaluation
Topic Subcategory
Value of Information
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology