INTRODUCTION A multicenter randomized clinical trial in France found an overall survival benefit of web-based patient-reported outcome (PRO)-based surveillance after initial treatment for lung cancer compared with conventional surveillance. The aim of this study was to assess the cost-effectiveness of this PRO-based surveillance in lung cancer patients. METHODS This medico-economic analysis used data from the clinical trial, augmented by abstracted chart data and costs of consultations, imaging, transportations, information technology, and treatments. Costs were calculated based on actual reimbursement rates in France, and health utilities were estimated based on scientific literature review. Willingness-to-pay thresholds of €30,000 per quality-adjusted life year (QALY) and €90,000 per QALY were used to define a very cost-effective and cost-effective strategy, respectively. Average annual costs of experimental and control surveillance approaches were calculated. The incremental cost-effectiveness ratio was expressed as cost per life-year gained and QALY gained, from the health insurance payer perspective. One-way and multivariate probabilistic sensitivity analyses were performed. RESULTS Average annual cost of surveillance follow-up was €362 lower per patient in the PRO arm (€941/year/patient) compared to control (€1,304/year/patient). The PRO approach presented an incremental cost-effectiveness ratio of €12,127 per life-year gained and €20,912 per QALY gained. The probabilities that the experimental strategy is very cost-effective and cost-effective were 97% and 100%, respectively. CONCLUSIONS Surveillance of lung cancer patients using web-based PRO reduced the follow-up costs. Compared to conventional monitoring, this surveillance modality represents a cost-effective strategy and should be considered in cancer care delivery.

中文翻译：

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肺癌患者基于网络的患者报告结果监测的成本效益

引言 法国的一项多中心随机临床试验发现，与常规监测相比，肺癌初始治疗后基于网络的患者报告结果 (PRO) 监测的总体生存获益。本研究的目的是评估这种基于 PRO 的监测在肺癌患者中的成本效益。方法 该医学经济分析使用来自临床试验的数据，并辅以抽象图表数据和咨询、成像、运输、信息技术和治疗的成本。费用是根据法国的实际报销率计算的，而卫生公用事业是根据科学文献审查估计的。每个质量调整生命年 (QALY) 的支付意愿门槛为 30,000 欧元和 90 欧元，每个 QALY 000 分别用于定义非常具有成本效益和成本效益的策略。计算了实验和控制监测方法的平均年成本。从健康保险支付方的角度来看，增量成本效益比表示为每生命年增加的成本和 QALY 的增加。进行了单向和多变量概率敏感性分析。结果 与对照组（1,304 欧元/年/患者）相比，PRO 组（941 欧元/年/患者）中每位患者的平均年度监测随访成本低 362 欧元。PRO 方法的增量成本效益比为每增加一个生命年 12,127 欧元，每增加一个 QALY 为 20,912 欧元。实验策略非常划算和划算的概率分别为 97% 和 100%。结论 使用基于网络的 PRO 对肺癌患者的监测降低了随访成本。与传统监测相比，这种监测方式代表了一种具有成本效益的策略，应在癌症护理服务中予以考虑。