Cost-effectiveness of eRAPID eHealth intervention for online symptom management during chemotherapy
Session type: E-poster/poster
A randomized controlled trial (RCT) in UK of eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) online system showed better physical well-being during chemotherapy in patients with colorectal, breast or gynaecological cancers, when compared to usual care (UC). This study evaluated the cost-effectiveness of eRAPID being added to UC.
An embedded economic evaluation was conducted alongside the RCT. Costs and quality adjusted life years (QALYs) were compared over the 18 week trial. Incremental cost-effectiveness ratios (ICERs) were estimated and compared to the National Institute for Health and Care Excellence cost-effectiveness threshold. Uncertainty was explored using non-parametric bootstrapping and sensitivity analyses. Primary analysis was conducted from healthcare provider perspective, with additional analyses conducted from societal perspective to include patient out of pocket care costs. Exploratory analysis over 12 months was conducted for a subset of participants with longer follow up.
Over the 18 week trial of 508 patients, patients with eRAPID had the highest QALY gain and the lowest costs. These differences were small and not statistically significant. eRAPID had a 55-58% probability of being more cost-effective than UC. Patient costs were lower in the eRAPID group, indicating eRAPID may help patients access support needed within NHS services. Exploratory subgroup analysis by disease status indicated eRAPID may be more cost-effective in patients with early cancers (treated with curative intent) than metastatic cancers. Sensitivity analyses did not change the interpretation of the results. Exploratory 12 month analysis showed higher QALY gains with eRAPID but also higher costs.
Table 1: Cost-effectiveness results
Despite small differences in QALYs and costs, the analyses were indicative of the potential cost effectiveness of eRAPID for this population.
The findings extend the evidence of benefits from online monitoring in advanced cancers, offering a cost-effective model of care delivery during curative chemotherapy.