Health economic impact of active e-health support in patients with advanced and metastatic breast cancer.

Abstract

e13726 Background: The AGO-B/WSG PreCycle trial demonstrated that patients with advanced/metastatic HR+/HER2- breast cancer receiving palbociclib and endocrine therapy benefited from active e-Health support (AeHS) by Cankado PRO-React, showing improved time to deterioration (TTD) and reduced incidence of serious adverse events (SAE) compared to an "information only" approach. This work aims to quantify the potential health economic impacts of AeHS in this setting. Methods: We employed a Markov state model with one absorbing state (therapy discontinuation) to represent the time horizon for accumulating benefits. Monte-Carlo simulations of virtual trials provide estimated probability distributions for monetized benefits attributable to improved quality of life and reduced healthcare system burdens. To ensure generalizability across different healthcare contexts, the analysis considers a matrix of values describing key parameters like willingness to pay (WTP) and SAE valuation. Results: Monte-Carlo simulations reveal that active e-Health support (AeHS) offers significant health economic benefits, providing an average monthly value over 260 Euros from a German healthcare system perspective. Key findings include a hazard ratio (HR) for time to deterioration (TTD) of 0.698, suggesting a 30.2% reduced risk of quality of life decline, and an HR for serious adverse events (SAE) of 0.67, indicating a 33% reduction in risk compared to the control group. The economic valuation of these clinical benefits was modeled using a willingness-to-pay (WTP) framework, reflecting different stakeholder perspectives, including patients, payers, and society. Sensitivity analyses exploring various scenarios of WTP and SAE cost assumptions confirmed the robustness of the health economic benefits, with potential monthly value fluctuations depending on specific healthcare system conditions and economic valuation methods. Conclusions: In addition to extending the interval of high quality of life and SAE-free survival, AeHS by Cankado PRO-React or similar applications could provide significant intangible benefits from societal and patient perspectives. Future trials designed to detect improvements in medication adherence or time to therapy discontinuation could demonstrate further positive impacts of AeHS. Clinical trial information: NCT03220178 .