Cost-Utility Analysis of a Group Mindfulness Program Compared to an Education Support Program for Breast Cancer Survivors With Cognitive Impairment: Evidence From a Randomized Controlled Trial.

Abstract

Objective: To conduct an economic evaluation of a group mindfulness program compared to an education support program for breast cancer survivors (BCS).

Methods: The cost-utility analysis (cost per quality-adjusted life year [QALY]) was performed from a single-center randomized controlled trial in the United States. Data from 181 BCS were included in the analysis (91 from the mindfulness-based stress reduction for breast cancer, MBSR(BC) and 90 from the Breast Cancer Education Support, (BCES)). Analyses were conducted from two perspectives: societal and healthcare system. The EuroQol EQ-5D-5L was used to measure quality of life and the Client Service Receipt Inventory (CSRI) was used to measure health services utilization from baseline through 26 weeks. The impact of MBSR(BC) on health services utilization and costs was estimated with generalized linear models.

Results: In the reference case analyses (societal perspective), the average total cost in the MBSR(BC) group was $5744 compared with $6140 in the BCES group. At the end of follow-up, the MBSR(BC) group dominated BCES in terms of Incremental Cost Utility Ratio (ICUR), with MBSR(BC) providing an incremental cost of -$541 (95% CI: -$3400, $2318) and a 0.021 QALY (95% CI: -0.014, 0.055). Net monetary benefit (NMB) analysis showed that MBSR(BC) has a higher probability of achieving positive NMB across a range of possible societal willingness-to-pay for improving quality of life.

Conclusions: Our findings suggest that MBSR(BC) is likely to be cost-effective for breast cancer survivors over 6 months. Cost savings primarily resulted from reduced ER and hospital admissions and tests.