J Palliat Med. 2025 Sep 16. doi: 10.1177/10966218251374527. Online ahead of print.
ABSTRACT
Background: People with advanced cancer often face significant challenges in everyday activities, especially within their home environments, where they spend most of their time. The Cancer Home-Life Intervention is an occupational therapy-based program supporting everyday activities in people with advanced cancer living at home. Aim: To examine the cost-utility and cost-effectiveness of the Cancer Home-Life Intervention compared to usual care over six months. Methods: This economic evaluation with a societal perspective was conducted alongside a randomized controlled trial (ClinicalTrials.gov: NCT02356627). Quality-adjusted life years (QALYs) and activities of daily living motor ability accounted for the outcome. Costs included primary and secondary health care, domestic care, assistive devices, and participants’ out-of-pocket costs. A total of 242 adults with advanced cancer were included from two Danish University Hospitals and randomized 1:1 to the Cancer Home-Life Intervention or usual care. Primary analysis included 172 participants alive at six months follow-up. Results: The intervention showed no statistically significant improvement in either QALYs or activities of daily living motor ability compared to usual care. However, the cost-utility analysis revealed a 72% probability of the intervention being cost-effective, regardless of the willingness-to-pay threshold per QALY gained. The probability of cost-effectiveness for activities of daily living motor ability started at 26% and increased to 58%. Sensitivity analyses supported these findings. Conclusion: The Cancer Home-Life Intervention showed limited potential for cost-effectiveness compared to usual practice. The cost-utility analysis revealed a 72% probability of cost-effectiveness. However, these findings should be interpreted cautiously due to small, nonstatistically significant improvements in QALYs.
PMID:40955537 | DOI:10.1177/10966218251374527
