QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Psychooncology. 2024 Jan;33(1):e6243. doi: 10.1002/pon.6243. Epub 2023 Nov 9.
To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT).
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.
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.
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.
对原发性脑肿瘤（PBT）患者的远程医疗心理支持干预进行经济评估。
在一项随机对照试验中，对为期 6 个月的试验内成本-效用分析进行了比较，比较了定制的远程医疗-心理支持干预与标准护理（SC）。数据来自远程医疗脑瘤认知治疗（Tele-MAST）试验调查数据、项目记录和行政医疗保健索赔。质量调整生命年（QALY）是根据 EuroQol-5D-5L 计算的。使用 2000 次迭代的非参数自举法确定抽样不确定性。使用多重插补处理缺失数据。
Tele-MAST 试验纳入了 82 名参与者，于 2018 年至 2021 年在澳大利亚昆士兰州进行。当包含所有医疗保健索赔时，Tele-MAST 的增量成本节约为 -AU$4327（95%CI：-AU$8637，-AU$18），而增量 QALY 获益较小，为 0.03（95%CI：-0.02，0.08）。在愿意支付每增加一个 QALY 获益 50000 澳元的阈值下，Tele-MAST 与 SC 相比具有 87%的成本效益可能性。当仅包括与心理相关的医疗保健费用时，每增加一个 QALY 获益的增量成本为 AU$10685（95%CI：主导，AU$24566），净货币收益为 AU$534（95%CI：AU$466，AU$602），干预具有成本效益的可能性为 65%。
基于这项小型随机对照试验，Tele-MAST 干预是改善澳大利亚 PBT 患者生活质量的一种具有成本效益的干预措施。接受干预的患者的整体医疗保健成本明显低于 SC 组的患者。在心理保健服务方面的成本没有显著差异。
