Cost-effectiveness analysis of a virtually administered pain coping skills training intervention in women with breast cancer in underserved areas.

چکیده اصلی

OBJECTIVES: Women with cancer who live in medically underserved areas could benefit from behavioral pain interventions, but access is limited. A randomized trial reported that a 4-session virtual program incorporating pain coping skills training (mPCST) was effective in improving pain outcomes compared to an attention-control condition. We performed a cost-effectiveness analysis of mPCST vs. control. METHODS: Data on medical resource use, therapist time, and participants' attendance at intervention sessions and time associated with travel and using a mobile app were collected. The 5-level EuroQol 5-Dimension (EQ-5D-5L), a preference-weighted measure of health-related quality of life (HRQOL), was administered at baseline, after the intervention period, and 3 and 6 months later. Medicare payments were used to value medical resource use and therapist time to deliver mPCST. Patient time was valued using the average US wage. RESULTS: Medical resource utilization was similar for both groups, but hospitalizations trended higher in the mPCST group. EQ-5D-5L preference weights were higher by an average of 0.066 (p = 0.04) with mPCST across the follow-up period, representing an incremental gain of 0.04 quality-adjusted life years (QALYs) (95% CI: 0.00-0.08). When including the base-case cost of mPCST of \$500 vs. \$0 for the control group, the incremental cost-effectiveness ratio (ICER) was \$12,725 per QALY (95% CI: 5,566-69,343). Including the value of patient time added \$303 to mPCST costs resulting in an ICER of \$20,438 per QALY (95% CI: 9,051-111,403). SIGNIFICANCE OF RESULTS: mPCST is a cost-effective program that improves HRQOL for women with cancer living in medically underserved areas.

ترجمه فارسی چکیده

هدف: بررسی هزینه‌های مؤثر یک برنامه مجازی ۴ جلسه‌ای شامل آموزش مهارت‌های مقابله با درد (mPCST) نسبت به گروه کنترل. روش‌ها: داده‌های استفاده از منابع پزشکی، زمان درمانگر و حضور شرکت‌کنندگان جمع‌آوری شد. معیار EQ-5D-5L برای کیفیت زندگی مرتبط با سلامت در زمان‌های مختلف پرسیده شد. هزینه‌ها بر اساس پرداخت‌های Medicare و میانگین دستمزد آمریکا ارزش‌گذاری شدند. نتایج: وزن ترجیحی EQ-5D-5L در گروه mPCST به طور متوسط 0.066 بالاتر بود (p = 0.04). نسبت هزینه‌های مؤثر افزایشی (ICER) 12,725 دلار به ازای هر سال زندگی با کیفیت (QALY) گزارش شد. نتیجه‌گیری: mPCST یک برنامه هزینه‌های مؤثر است که کیفیت زندگی را بهبود می‌بخشد.

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