Cost-Effectiveness of Remote Symptom Monitoring During Adjuvant Endocrine Therapy in Breast Cancer.
Xin Hu, Freddie Yang, Andrea N Curry et al.
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In 30 seconds
This economic evaluation used data from a randomized trial of adult women initiating adjuvant endocrine therapy for early-stage breast cancer, comparing remote symptom monitoring via an app, an app with tailored feedback, and enhanced usual care. Among 214 participants with complete data, app-only monitoring had lower mean total costs than enhanced usual care ($6682.15 vs $11 596.10), while estimated quality-adjusted life years were similar. At $100 000 per QALY, the app-only group’s incremental net monetary benefit was $5813.95 (95% uncertainty interval, -$1860.00 to $16 492.58).
Key findings
- Mean total costs were $6682.15 for app-only monitoring and $11 596.10 for enhanced usual care; the difference was -$4913.95 (95% CI, -$12 864.27 to $3036.37).
- Estimated QALYs were similar across groups: 0.79 with the app, 0.78 with app plus feedback, and 0.78 with enhanced usual care.
- At $100 000 per QALY, incremental net monetary benefit was $5813.95 (95% UI, -$1860.00 to $16 492.58) for app-only monitoring and $88.25 (95% UI, -$14 781.73 to $13 849.34) for app plus feedback.
- Across willingness-to-pay thresholds of $0 to $200 000 per QALY, the app-only intervention had a 68.2% to 78.1% probability of being cost-effective versus enhanced usual care.
Why it matters
Symptom burden can undermine adherence to adjuvant endocrine therapy, while remote monitoring may require resources from patients and clinical teams. These findings suggest that an app-only approach could reduce costs without an apparent difference in estimated QALYs, and may offer a more straightforward model for supportive care. The uncertainty around cost-effectiveness remains relevant when interpreting its potential value.
What to keep in mind
Complete data were available for 214 of 304 randomized participants. Follow-up for the economic evaluation was 12 months, and cost and cost-effectiveness estimates were uncertain, with intervals spanning no difference.