E-PROs in oncology: Improving treatment adherence to treatment while reducing emergency care and costs for patients with gastrointestinal malignancies receiving systemic therapy.

Abstract

11109 Background: Patients with cancer undergoing systemic therapy are prone to experience symptom-related complications which may lead to emergency room visits (ERV) and non-planned inpatient admissions (NIA), resulting in increased costs to health systems. Symptom monitoring and proactive management based on ePRO protocols have been shown to reduce acute care utilization; however, the economic impact of this intervention remains incompletely characterized. In addition, patients monitored through ePRO systems tend to remain on active anticancer treatment for longer periods, with fewer unplanned treatment interruptions. Our aim was to evaluate the economic impact of a remote Comprehensive Companion Program (CCP) in a private health system. Methods: We conducted a retrospective study within the AUNA oncological network in Lima, Peru. Adult patients with GI malignancies receiving systemic therapy who experienced at least one ERV or NIA between June 2021 and July 2022 were included. Patients were grouped according to enrollment in a remote CCP or receipt of usual care. Costs related to ERV and NIA were analyzed from a payer’s perspective and adjusted by time on treatment to estimate average monthly cost per-patient. Data were analyzed using descriptive and comparative statistical methods. Results: A total of 97 patients with comparable baseline clinical characteristics were included (50 in the CCP group and 47 with usual care). Patients in the CCP group had a significantly longer time on treatment (median 235.5 vs 151 days; p = 0.0009), driven primarily by patients with metastatic disease. When costs associated with ERV and NIA were normalized by treatment duration, the CCP group was associated with significantly lower monthly acute care costs. Median monthly variable costs per patient were USD $147.14 versus $449.70 (p = 0.0137), representing an 67% of costs reduction in monthly variable costs per patient. Similarly, median monthly prorated expenses per patient were $220.33 versus $636.66 (p = 0.0151), corresponding to an approximate 65% reduction in monthly prorated expenses. Conclusions: Our study showed that patients enrolled in a CCP incorporating e-PRO based symptom monitoring remained on treatment for longer; however, this was associated with significantly lower time-adjusted acute care costs. These findings highlight the potential value of the CCP in reducing cancer care–related costs, while acknowledging that the results are limited to a private health care setting.