Cost-effectiveness of an intervention to reduce fear of cancer recurrence: The ConquerFear randomized controlled trial

Psychooncology. 2019 May;28(5):1071-1079. doi: 10.1002/pon.5056. Epub 2019 Apr 2.

Abstract

Objective: Alongside a randomized controlled trial (RCT) evaluating the efficacy of the ConquerFear intervention for reducing fear of cancer recurrence in cancer survivors, the cost-effectiveness of this novel intervention was assessed, primarily from the health sector perspective, with broader societal productivity impacts assessed.

Methods: Health care resource use was collected by a tailored cost diary. Incremental costs were calculated as the difference in total costs between the intervention and control groups. Incremental cost-effectiveness ratios (ICERs) were estimated by cost-effectiveness and cost-utility analyses, comparing incremental costs with incremental outcomes measured. Nonparametric bootstrap analysis was performed to evaluate uncertainty in costs and outcomes.

Results: Cancer survivors were randomized into ConquerFear (n = 121), or an active control group receiving relaxation training (n = 101). Participants received on average 3.69 sessions, incurring an average cost of $297 per person, with no group difference. The ITT analysis results indicated a mean ICER $34 300 per quality-adjusted life year (QALY) with average incremental cost $488 and health gain of 0.0142 QALYs, from the health care sector perspective. Bootstrap analysis showed 30% of iterations were dominant and overall 53% ICERs were cost-effective as judged by the commonly used $50 000/QALY threshold.

Conclusions: The ConquerFear intervention is associated with a modest cost and may provide good value for money, but further evidence is needed. Long-term cost-effectiveness needs further investigation to capture full benefits from the intervention beyond the trial follow-up.

Keywords: cancer survivor; cost-effectiveness analysis; cost-utility analysis; economic evaluation; fear of recurrence; oncology; randomized controlled trial.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cancer Survivors / psychology*
  • Cost-Benefit Analysis
  • Fear / psychology*
  • Female
  • Humans
  • Male
  • Metacognition
  • Middle Aged
  • Neoplasm Recurrence, Local / psychology*
  • Psychotherapy / methods*
  • Quality-Adjusted Life Years
  • Self-Control

Associated data

  • ANZCTR/ACTRN12612000404820