Cost-utility of an eHealth application ‘Oncokompas’ that supports cancer survivors in self-management: results of a randomised controlled trial

Abstract

Purpose The eHealth self-management application 'Oncokompas' was developed to support cancer survivors in monitoring health-related quality of life (HRQOL) and symptoms, and obtaining personalized feedback and options for supportive care. The aim of this study was to assess the cost-utility of Oncokompas compared with care as usual (CAU) among cancer survivors. Methods Survivors were randomly allocated to the intervention or control group. Direct (non-)medical, indirect non-medical costs, and HRQOL were measured at 3-and 6-month follow-up, using iMTA Medical Consumption and Productivity Costs and the EuroQol-5D questionnaires. Mean cumulative costs and quality-adjusted life-years (QALYs) were compared between both groups. Results In total, 625 survivors were randomized into intervention (n = 320) or control group (n = 305). Base case analysis showed that incremental costs from a societal perspective were − €163 (95% CI, − 665 to 326), and incremental QALYs were 0.0017 (95% CI, − 0.0121 to 0.0155) in the intervention group compared with those in the control group. The probability that, compared with CAU, Oncokompas is more effective was 60%, less costly 73%, and both more effective and less costly 47%. Sensitivity analyses showed that incremental costs vary between − €40 and €69, and incremental QALYs vary between − 0.0023 and − 0.0057. Conclusion Oncokompas is likely to be equally effective on utilities, and not more expensive than CAU, and will therefore contribute to sustainable cancer survivorship care in a (cost-)effective manner. Implications for Cancer Survivors Oncokompas seems to improve HRQOL and reduces the burden of several tumour-specific symptoms, while costs from a societal perspective are similar to CAU.

Reasons for not reaching or using web-based self-management applications, and the use and evaluation of Oncokompas among cancer survivors, in the context of a randomised controlled trial

“…The web-based self-management application Oncokompas was developed to support cancer survivors in self-management, and contains three components: 1) measure: monitoring health-related quality of life and cancer-generic and tumour-specific symptoms by means of patient-reported outcome measures (PROMs), 2) learn: providing tailored information based on PROM scores, and 3) act: providing a personalized overview with recommended supportive care options ( van der Hout et al, 2017 ). A randomised controlled trial (RCT) showed that Oncokompas is effective to reduce symptoms and improve HRQOL in cancer survivors ( van der Hout et al, 2020b ), and is not more expensive than usual cancer survivorship ( van der Hout et al, 2020a ). These are important conditions in order to implement Oncokompas in routine cancer survivorship care.…”

“…In our previous report, we investigated the reach by assessing the eligibility rate and participation rate, in the context of an RCT on the efficacy and cost-utility of Oncokompas ( van der Hout et al, 2020b , van der Hout et al, 2020a , van der Hout et al, 2017 ). We found that 68% of the respondents were eligible to use Oncokompas (they had access to the internet and an e-mail address), of whom 45% agreed to participate in the RCT on Oncokompas.…”

Identifying unmet needs and limitations in physical health in survivors of Head and Neck Cancer

“…Research has shown it to be feasible, equally effective on utilities, and not more expensive than usual care. (Duman‐Lubberding et al, 2016 ; Hout et al, 2020 ; Van Der Hout et al, 2017 ).…”

Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial

“…It is essential to provide robust evidence from randomised trials about the effectiveness of psychologically-based interventions intended to improve QoL and its subscales. Thus far, such intervention studies in HNC patients have produced insufficient data to support their effectiveness for improving quality of life [23][24][25][26][27]. However, there is evidence of benefit in other cancers, for example, a randomised trail reporting symptom monitoring with patient-reported outcomes during routine cancer treatment [28].…”