OnCo
ideasIdea

Pay for supervised exercise the way we pay for drugs

A large trial showed a structured exercise programme improved survival after bowel cancer. Almost no health system pays for it, so almost no patient gets it.

A randomised trial of a three-year structured exercise programme after colon cancer chemotherapy reported improved disease-free survival, an effect size comparable with some adjuvant drugs at a small fraction of the cost. Reimbursement codes, referral pathways and trained providers are the barriers. Cardiac rehabilitation is the working template for how a supervised exercise service can be funded and audited at scale.

Hypothesis
Introducing a reimbursed structured exercise benefit for curative-intent cancer patients achieves at least 40% uptake and is cost-saving within five years through reduced recurrence and hospital use.
Rationale
Cardiac rehabilitation moved from trial evidence to funded service with measurable population benefit, and the delivery model transfers directly. Exercise also improves treatment tolerance, which supports dose intensity.
What would test it
A payer pilot in one region with a defined benefit and mandatory registry; measure uptake, adherence, treatment completion rates and total cost of care against matched controls.
Maturity
early clinical
Who has to act
payer
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks

Key papers

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Connected

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