Cost-Effectiveness of eRAPID eHealth Intervention for Symptom Management During Chemotherapy.

Area of Science:

• Health Informatics
• Health Economics
• Oncology

Background:

• Online symptom monitoring systems can improve cancer patient care.
• The electronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID) system was previously shown to enhance symptom control and patient self-efficacy.
• Evaluating the cost-effectiveness of such eHealth interventions is crucial for healthcare system integration.

Purpose of the Study:

• To assess the cost-effectiveness of the eRAPID eHealth intervention compared to usual care for cancer patients undergoing systemic treatment.
• To analyze costs and quality-adjusted life-years (QALYs) from both healthcare provider and societal perspectives.
• To explore potential longer-term effects and subgroup variations in cost-effectiveness.

Main Methods:

• An embedded economic evaluation was conducted alongside a randomized controlled trial.
• Costs and QALYs were compared over an 18-week period.
• Incremental cost-effectiveness ratios (ICERs) were calculated and analyzed using bootstrapping and sensitivity analyses; 12-month follow-up data were collected for a subset.

Main Results:

• The eRAPID group demonstrated higher QALY gains and lower costs over 18 weeks, though not statistically significant.
• eRAPID showed a 55%-58% probability of being more cost-effective than usual care, with lower patient out-of-pocket expenses.
• Cost-effectiveness was observed for early-stage cancers but not for metastatic disease in exploratory subgroup analyses.

Conclusions:

• Online symptom monitoring via the eRAPID system presents potential cost-effectiveness when integrated with usual cancer care.
• The intervention appears particularly valuable for patients undergoing adjuvant systemic treatment for early-stage cancers.
• Further investigation into long-term impacts and specific patient subgroups is warranted.