Value Of Implementation Of Physical Exercise For Cancer Survivors

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Objectives: To evaluate which strategy for implementing exercise interventions for cancer survivors and increasing providers´ adherence to the exercise guidance has the highest expected value, using value-of-implementation analysis.

Methods: The net-benefit framework underpinning health economic evaluations is used to conduct a value-of-implementation analysis considering seven implementation strategies (ISTs), including continuing medical education (CME), educational outreach visits (EOV), educational printed materials (EPM), local opinion leaders (LOPL), audit and feedback (AF), reminder systems (RS), and a multifaceted strategy (MF) consisting of CME and AF. The analysis consists of four steps; (1) analysing the expected value of perfect implementation (EVPIM) (2) assessing the estimated costs of the various ISTs, (3) comparing the ISTs´ costs to the EVPIM to decide which of these are considered cost-effective, and (4) assessing the total net benefit of the ISTs to identify which strategy has the greatest value.

Results: The EVPIM for physical exercise in the Netherlands is €522m, which represents the maximum value that could be achieved if the guidance was implemented perfectly with a 100% adherence. The costs of the implementation strategies are lowest for PEM with €710,600 and highest for MF with €2,173,700. All ISTs´ costs are well below the EVPIM and thus all ISTs are cost-effective. The net-benefit of the ISTs ranges from €15,753,000 for PEM to €10,150,500 for RS.

Conclusions: All evaluated implementation strategies are a cost-effective way of implementing physical exercise interventions for cancer survivors and increasing health professionals´ adherence to this guideline. However, all strategies contribute only marginally to achieving the highest possible value of implementation. This suggests that investing in more intensive implementation would be justified given the expected net-benefit.
Original languageEnglish
Article numberPA456
JournalValue in health
Issue number7
Publication statusPublished - Nov 2015
EventISPOR 18th Annual European Congress 2015 - MiCo - Milano Congressi, Milan, Italy
Duration: 7 Nov 201511 Nov 2015
Conference number: 18


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