Aims: Although the effectiveness of many psychosocial interventions for people with cancer has been established, one barrier to implementation in routine clinical care is a lack of data on cost-effectiveness. We conducted a systematic review of published literature to assess the cost-effectiveness of psychosocial interventions for improving psychological adjustment among people with any type of cancer.
Methods: Systematic review, study quality appraisal,and narrative synthesis.
Results: Eight studies involving 1,668 patients were identified. Four of these reported outcomes in a cost per quality adjusted life year (QALY) framework. Six studies reported psychosocial interventions to be cost-effective for improving health-related quality of life, mood, pain, distress, or fear of cancer progression, compared to usual care. Of these six studies, three were cognitive behavioural therapy based interventions, one was a nurse-delivered telephone follow-up plus educational group program, one was a group-based exercise and psychosocial intervention, and one was a series of 10 face-to-face or telephone-based individual support sessions delivered by a nurse. The quality of studies according to the CHEC-list criteria was good overall; however, some studies were limited by their choice of outcome measure and omission of important categories of costs.
Conclusions: Several psychosocial interventions, particularly those based on cognitive behavioural therapy, have been demonstrated to represent good value for money in cancer care. The quality of studies can be improved with a clear definition of the economic question, inclusion of all relevant costs, and consideration of utility-based quality of life measures for QALY estimation. Further research is needed to assess the cost-effectiveness of psycho-educational interventions.
Systematic review registration: PROSPERO Registration Number: CRD42014006370.