PHYSICAL ACTIVITY AND OUT OF POCKET HEALTH CARE EXPENDITURES AMONG BREAST CANCER SURVIVORS IN THE UNITED STATES
Author(s)
Nastaran Nemati, PhD Candidate, Tolulope Oladele, PhD Candidate, Jayani Jayawardhana, PhD, Ensieh Shahrjooihaghighi, PhD Candidate;
University of Kentucky, LEXINGTON, KY, USA
University of Kentucky, LEXINGTON, KY, USA
OBJECTIVES: Improvements in early detection and treatment have increased the number of long-term breast cancer survivors, many of whom experience ongoing healthcare needs and financial burden due to out-of-pocket (OOP) healthcare spending. Physical activity is a modifiable behavior associated with improved health outcomes in cancer survivors, but its potential role in reducing patient-level financial burden remains understudied. This study evaluated the association between adherence to recommended physical activity guidelines and annual out-of-pocket healthcare expenditures among breast cancer survivors in the United States.
METHODS: We conducted a cross-sectional observational study using pooled, nationally representative data from the 2017-2023 Medical Expenditure Panel Survey (MEPS). The final analytic sample included 2,815 women with a history of breast cancer. Adherence to PA guidelines was defined as engaging in at least 30 minutes of moderate- or vigorous-intensity activity on five or more days per week. We applied Inverse Probability of Treatment Weighting (IPTW) to estimate the average treatment effect (ATE) of PA adherence on log-transformed annual OOP expenditures. This causal inference method adjusted for critical sociodemographic, insurance, and clinical characteristics.
RESULTS: Among breast cancer survivors, 43.3% met the physical activity guidelines. The average annual out-of-pocket (OOP) expenditure in the study sample was $1,949 (95% CI: $1,700-$2,198). After IPTW adjustment, adherence to PA guidelines was significantly associated with a 14.3% reduction in annual OOP expenditures compared with non-adherence (p = 0.037). This corresponds to an approximate annual reduction of $280 in out-of-pocket spending among physically active survivors.
CONCLUSIONS: Adherence to physical activity guidelines is associated with significantly and meaningfully lower out-of-pocket healthcare expenditures among U.S. breast cancer survivors. Promoting PA may yield important financial benefits that advance patient-centered value in survivorship care.
METHODS: We conducted a cross-sectional observational study using pooled, nationally representative data from the 2017-2023 Medical Expenditure Panel Survey (MEPS). The final analytic sample included 2,815 women with a history of breast cancer. Adherence to PA guidelines was defined as engaging in at least 30 minutes of moderate- or vigorous-intensity activity on five or more days per week. We applied Inverse Probability of Treatment Weighting (IPTW) to estimate the average treatment effect (ATE) of PA adherence on log-transformed annual OOP expenditures. This causal inference method adjusted for critical sociodemographic, insurance, and clinical characteristics.
RESULTS: Among breast cancer survivors, 43.3% met the physical activity guidelines. The average annual out-of-pocket (OOP) expenditure in the study sample was $1,949 (95% CI: $1,700-$2,198). After IPTW adjustment, adherence to PA guidelines was significantly associated with a 14.3% reduction in annual OOP expenditures compared with non-adherence (p = 0.037). This corresponds to an approximate annual reduction of $280 in out-of-pocket spending among physically active survivors.
CONCLUSIONS: Adherence to physical activity guidelines is associated with significantly and meaningfully lower out-of-pocket healthcare expenditures among U.S. breast cancer survivors. Promoting PA may yield important financial benefits that advance patient-centered value in survivorship care.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD114
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology