Table 2.

Outcomes of included economic evaluations

Authors (Country)	Gordon et al. [12] (Australia)	Gordon et al. [26] (Australia)	Haines et al. [13] (Australia)	May et al. [27] (The Netherlands)	Mewes et al. [29] (The Netherlands)	Perrier et al. [25] (France)	Van Waart et al. [28] (The Netherlands)
Type of study	CEA & CUA, Model based, Markov model 12 months	CEA & CUA Trial based	CUA Trial based	CUA Trial based	CUA Model based Markov model 5 years	CEA Trial based	CEA & CUA Trial based
Perspective	Societal	Service provider, private	Societal	Societal	healthcare system perspective	French national insurance perspective	Societal
Costs (Currency, price date, types of costs, sources of cost data, valuation of costs. discount rate)	2004 AUS $, Direct and indirect, Literature, national tariffs No discounting Average cost DAART AUS $342 STRETCH AUS $1038 Usual Care (UC) AUS $189 Incremental cost versus UC DAART AUS $133 STRETCH AUS $941	2014 AUS $, Intervention, out of pocket, Trial records, invoices No discounting Mean costs Service provider AUS $967 Private AUS $838 Usual care AUS $20	2006 AUS $, Intervention, Direct health and productivity Trial data, Market prices, Australian DRG cost weights, mean wage rates No discounting Total costs Median (IQR), mean Intervention AUS $3864 (2450, 10,076), 10,082 Control AUS $3594 (2316, 7992), 3819	2011 Euros €, Direct and indirect, Trial data, own cost price calculations, No discounting Total societal costs, Mean (SD) Intervention €25,105 (10,403) Control €22,215 (8652)	2011 Euros €, Intervention costs, Health care costs, Medication, Literature, national tariffs Discount rate 4% Total cost Intervention €2983 Control €2798	2012 Euros €, Intervention, total, Trial records, No discounting Total costs, mean (SD) Intervention €15,776 (9772) Control €18,475 (14,612)	2017 Euros €, Intervention, Direct Health care, Absenteeism, Unpaid productivity Trial data, National tariffs No discounting Total costs, mean (SE) OnTrack €29,589 (1615) OncoMove €31,133 (2236) Usual Care €28,714 (1984)
Effects (type of effects, sources of QALYs, discount rate)	Rehabilitated cases n (%) QALYs (Subjective Health Estimation (SHE) scale) No discounting Rehabilitated cases n (%) DAART 14 (45%) STRETCH 12 (48%) Usual care 99 (52%) Utility score, mean (SD) DAART 0.77 (0.19) STRETCH 0.79 (0.18) Usual care 0.73 (0.17)	Rehabilitated cases QALYs (EQ‐5D‐3L) No discounting Improvers Intervention 69 Usual care 21 Mean QALYs Intervention 0.846 Usual care 0.837	Utility scores (EQ‐5D‐3L) No discounting Utility score, mean (SD) Intervention 0.80 (0.21) Control 0.83 (0.18)	QALYs (EQ‐5D‐3L) No discounting QALYs total, mean (SD) Intervention 0.569 (0.03) Control 0.560 (0.04)	QALYs (EQ-5D derived/mapped from SF-6D) Discount rate 1.5% Total QALYs Intervention 4.399 Control 4.392	Change in BMI score VO2max gained No discounting Change in BMI score Intervention 0.05 Control 0.29 Change in VO2max Intervention 0.39 Control − 0.06	QALYs (EQ-5D-3L) General fatigue Physical fatigue No discounting QALYs gained, mean (SE) OnTrack 0.65 (0.01) OncoMove 0.63 (0.02) Usual Care 0.58 (0.02)
Outcomes	Incremental cost per rehab case DAART Dominated by UC STRETCH Dominated by UC ICER QALYs DAART versus UC AUS $1344 STRETCH versus UC AUS $14,478	ICER improvers Service provider AUS $ 2644 Private AUS $ 2282 ICER QALYs Service provider AUS $105,231 Private AUS $90,842	Only 5% probability that the intervention would be both less costly and more effective than the control	Incremental costs €2912 Incremental QALYs 0.01 ICER was €291,200	Incremental costs €185 Incremental QALYs 0.0067 ICER €28,078	ICERS €-11,159 per BMI unit lost €-6030 per estimated aerobic capacity unit gained for VO2max Intervention dominates usual care	Incremental cost OnTrack versus UC 1184 OncoMove versus UC 2571 Incremental QALYs OnTrack versus UC 0.04 OncoMove versus UC 0.04 ICERs Improvement in general fatigue OnTrack versus UC 788 OncoMove versus UC 4711 Improvement in physical fatigue OnTrack versus UC 1402 OncoMove versus UC 10,384 QALYs OnTrack versus UC 26,916 OncoMove versus UC 70,052
Sensitivity analyses conducted	A one-way sensitivity analysis was performed for several cost and outcome estimates PSA of cost-effectiveness inputs	One-way sensitivity of QALYs and costs PSA of cost-effectiveness inputs	None	Scenario analysis—Cost-effectiveness from healthcare perspective	One-way sensitivity PSA	PSA	Scenario analysis
Results of sensitivity analyses	The ICERs for the STRETCH and DAART interventions remained robust to nearly all sensitivity analysis, with the exception of varying utility scores to their lower confidence limits when QALYs were the outcome used	Sensitivity analyses indicated that the incremental cost‐effectiveness ratios using QALYs gained were most sensitive when the EQ‐5D-3L utility values were varied within their 95% confidence limits. Other variations in variables tested (e.g. leasing costs) produced negligible changes to the incremental cost-effectiveness ratios. The likelihood of the service provider model being cost-effective was 44.4%, and 46.3% for the private model, at a cost-effectiveness threshold of AUS$50 000 per QALY gained	NA	Similar to results of the baseline analysis	The outcomes were most influenced by (1) the utility values of the “menopausal symptoms” and “reduction in menopausal symptoms” health states, and (2) the duration of the treatment effect, with shorter effect duration resulting in lower cost-effectiveness The outcomes of this study were most sensitive to a reduction of the duration of the treatment effect from 5 to 3 and 1.5 years	Probability that intervention is cost-effective reached 56% for the BMI outcome measure and 69% for the VO2max outcome measure	The probability of cost-effectiveness for both comparators was greater amongst compliant participants
Conclusion	Rehabilitated cases—not cost-effective when rehabilitated cases were used as the outcome for generating the ICER, the usual care group was superior to both STRETCH and DAART interventions When QALYs were used, the DAART group was more effective than both STRETCH and usual care	In this study, the EQ‐5D‐3L was not sensitive to capture the intervention effect, and therefore, QALYs were not entirely appropriate for this context In terms of the numbers of women reporting clinically significant improvements in quality of life, the intervention, using either service model, may be cost‐effective at approximately A$2400 per improver (or A$300 per month)	Not cost-effective Provision of multimodal exercise programmes will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of questionable economic efficiency	Not cost-effective Probability that the intervention would be cost-effective at 20,000 threshold is 2%	Physical Exercise is a cost-effective strategy for alleviating treatment-induced menopausal symptoms in this population	On the basis of both cost and effectiveness, the study finds potential advantages in using 6-month supervised physical activity programme in addition to the usual dietetic care instead of one dietetic care only	OncoMove is not likely to be cost-effective Depending on the decision-makers’ willingness-to-pay, OnTrack could be considered cost-effective in comparison with UC Both interventions had a low probability of being cost-effective for physical fitness
Quality scorea	22	20	20	20	22	19

CEA Cost-effectiveness analyses, CI confidence interval, CUA cost–utility analyses, DAART Domiciliary Allied Health and Acute Care Rehabilitation Team, DRG Diagnosis-Related Grouping, EQ-5D-3L EuroQol generic health questionnaire 3 level version, ICER incremental cost-effectiveness ratio, IQR inter quartile range, PSA probabilistic sensitivity analyses, QALYs quality-adjusted life-years, SD standard deviation, SE standard error, STRETCH Strength Through Recreation Exercise Togetherness Care Health

^aQuality assessment based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement [34]