Background & Aims: People with primary brain tumour often face more impairments in physical, cognitive and behavioural function than other cancer groups and they also experience high levels of anxiety and depression. Despite the need for accessible psychosocial interventions to facilitate adjustment, a major barrier to wider uptake is a lack of data on their cost-effectiveness. Our aim was to undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor.
Methods: A cost-utility analysis over 6 months was performed comparing a tailored telehealth-psychological support intervention with standard care based on 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 2,000 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$4,386 (95%CI: $4,289, $4,482) while incremental QALY gains were slightly higher. The likelihood of Tele-MAST being cost-effective versus standard care was 87%. When psychological-related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95%CI: dominant, $24,566) and had a 65% likelihood of the intervention being cost-effective. There was little evidence of cost-offsets for lower psychological service uptake.
Conclusions: The Tele-MAST intervention is considered a cost-effective intervention for improving the quality of life of people with primary brain tumour in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in standard care but incurred similar costs for psychological health services.