Economic Analysis of Psychosocial Group Therapy in Women with Metastatic Breast Cancer
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Metastatic breast cancer is associated with psychological distress in one-third of patients. We examined the impact of group psychosocial support on health care costs in metastatic breast cancer. Psychosocial interventions have been shown to reduce psychological distress in these patients. In other diseases, depression and anxiety have been associated with higher health care system resource utilization.
Data on health care system resources utilization were collected as part of a Canadian multicenter randomized controlled trial of a supportive-expressive group support in metastatic breast cancer. Costs were obtained from one tertiary care hospital in Toronto. A cost minimization analysis was conducted since there was no survival difference; the primary endpoint of the study. Cost-effectiveness analyses were conducted for mood and pain.
Total health care utilization costs (including costs of the group therapy intervention) for the intervention and control groups were $31,715 and $28,189, respectively per patient. The difference in total costs between groups ($3,526) was not statistically significant (P = 0.53). The cost-effectiveness analysis for mood showed the intervention group to have an increased cost of $5,550 per patient for an effect size of 0.5 on the POMS scale. The corresponding cost for pain was $4,309. An exploratory analysis on patients who were more distressed at baseline showed a non-significant decrease in cost in favor of the intervention arm (difference of $3,911 P = 0.66).
Psychosocial intervention, in the form of supportive-expressive group support for metastatic breast cancer, does not lower health care system resource utilization.
Key wordsCost-effectiveness Metastatic breast cancer Psychotherapy
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Dr. Lemieux is supported on a Canadian Institute of Health Research (CIHR)/Canadian Association of Medical Oncologists/ Rx&D Research Fellowship program and Université Laval fellowship. The research was funded by the CIHR and the Canadian Breast Cancer Research Alliance.
- 1.Institute NC (1975–2001) SEER Cancer Statistics ReviewGoogle Scholar
- 2.Canadian Cancer Statistics (2003) National Cancer Institute of Canada, Health Canada, Canadian Cancer Society, Statistics Canada, Provincial/Territorial cancer registriesGoogle Scholar
- 18.Carlson LE, Bultz BD (2004) Efficacy and medical cost offset of psychosocial interventions in cancer care: making the case for economic analyses. Psychooncology 13:837–849; discussion 850–856Google Scholar
- 21.Hewitt M, Herdman R, Holland J (eds) (2004) Meeting psychosocial needs of women with breast cancer, 1st edn. The National Academy Press, WashingtonGoogle Scholar
- 26.Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale, NJGoogle Scholar