, Volume 100, Issue 2, pp 183-190

Economic Analysis of Psychosocial Group Therapy in Women with Metastatic Breast Cancer

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

Psychosocial intervention, in the form of supportive-expressive group support for metastatic breast cancer, does not lower health care system resource utilization.

Lemieux, J., Chappell, H., Topp, A., Goodwin P. J. for the Breast Expressive Supportive Therapy Study Investigators; Division of Epidemiology, Samuel Lunenfeld Research Institute of Mount Sinai Hospital, University of Toronto, Toronto. Does supportive-expressive group therapy for metastatic breast cancer patients lower health care services resource utilization? Canadian Association of Medical Oncologists, Toronto, April 15 2004 (oral presentation)
Lemieux, J., Chappell, H., Topp, A., Goodwin, P. J. for the Breast Expressive Supportive Therapy Study Investigators; Division of Epidemiology, Samuel Lunenfeld Research Institute of Mount Sinai Hospital, University of Toronto, Toronto. Does supportive-expressive group therapy for metastatic breast cancer patients lower health care services resource utilization? American Society of Clinical Oncology Proceedings, 22(14S): 532S, 2004 (abstract 6052) (Poster presentation).
Lemieux, J., Chappell, H., Topp, A., Goodwin P. J. for the Breast Expressive Supportive Therapy Study Investigators; Division of Epidemiology, Samuel Lunenfeld Research Institute of Mount Sinai Hospital, University of Toronto, Toronto. Does supportive-expressive group therapy for metastatic breast cancer patients lower health care services resource utilization? Department of Medicine Annual Research and Education Day, University of Toronto, June 21st 2004 (poster presentation)