Cost-utility analysis of a telehealth psychological support intervention for people with primary brain tumor : Telehealth Making Sense of brain tumor

Objective: To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT).

Methods: A within-trial cost-utility analysis over 6 months was performed comparing a tailored telehealth-psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele-MAST) trial survey data, project records, and administrative healthcare claims. Quality-adjusted life years (QALYs) were calculated based on the EuroQol-5D-5L. Non-parametric bootstrapping with 2000 iterations was used to determine sampling uncertainty. Multiple imputation was used for handling missing data.

Results: The Tele-MAST trial included 82 participants and was conducted in Queensland, Australia during 2018–2021. When all healthcare claims were included, the incremental cost savings from Tele-MAST were -AU$4,327 (95% CI: −$8637, −$18) while incremental QALY gains were small at 0.03 (95% CI: −0.02, 0.08). The likelihood of Tele-MAST being cost-effective versus SC was 87% at a willingness-to-pay threshold of AU$50,000 per QALY gain. When psychological-related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95% CI: dominant, $24,566) and net monetary benefits were AU$534 (95% CI: $466, $602) with a 65% likelihood of the intervention being cost-effective.

Conclusions: Based on this small randomized controlled trial, the Tele-MAST intervention is a cost-effective intervention for improving the quality of life of people with PBT in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in SC. There was no significant difference in costs incurred for psychological health services.

© 2023 John Wiley & Sons Ltd.

Funding:
National Health and Medical Research Council. Grant Number: 1152217
Cancer Council Queensland
Metro South Health

The trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618001737224).