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Cost‐effectiveness of the BRECONDA decision aid for women with breast cancer: Results from a randomized controlled trial
Author(s) -
Parkinson Bonny,
Sherman Kerry A.,
Brown Paul,
Shaw LauraKate E.,
Boyages John,
Cameron Linda D.,
Elder Elisabeth,
Lam Thomas
Publication year - 2018
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4698
Subject(s) - breast cancer , randomized controlled trial , cost effectiveness , medicine , gynecology , oncology , medical physics , physical therapy , cancer , risk analysis (engineering)
Objective To report on the cost‐effectiveness of BRECONDA (Breast RECONstruction Decision Aid), a web‐based decision aid to facilitate decisions regarding breast reconstruction surgery, with usual care for women with breast cancer. Methods The economic evaluation was conducted alongside a randomized controlled trial. Women diagnosed with breast cancer or ductal carcinoma in situ and eligible for breast reconstruction following mastectomy were randomized to access BRECONDA for 6 months + usual care (n = 106) or usual care (n = 116) and were assessed at baseline preintervention, and then 1‐month and 6‐months post‐randomization. Decisional conflict, satisfaction with information, decisional regret, and utilities were assessed by using maximum‐likelihood linear mixed effects models. Costs included the fixed costs of BRECONDA , health care provider time, and health care resource use. Nonparametric bootstrapping was used to estimate incremental cost‐effectiveness ratios. Results BRECONDA resulted in significantly less decisional conflict and greater satisfaction with information over time. Quality‐adjusted life years did not differ between participants who received the decision aid compared with usual care. The cost of BRECONDA was estimated to be small (AUD$10) relative to other health care interventions and resulted in decreased health care costs overall (AUD$764). Based on the point estimates, the decision aid was more effective and less costly (dominant) for all measures of effectiveness. It was estimated that the decision aid has an 87% probability of being cost‐effective at $60 000 per quality‐adjusted life year gained. Conclusions The BRECONDA web‐based intervention designed to facilitate decisions regarding breast reconstruction surgery is likely to be cost‐effective compared with usual care for women with breast cancer.