Women with cancer who live in medically underserved areas face limited access to behavioral pain interventions. A randomized trial examined a 4-session virtually delivered pain coping skills training program (mPCST) designed to improve pain outcomes for this population. The objective reported in the source was to perform a cost-effectiveness analysis of mPCST versus an attention-control condition using trial data on resource use, program delivery, patient time, and health-related quality of life measured over a 6-month follow-up.
Data collection in the trial included medical resource use, therapist time to deliver the intervention, participant attendance at intervention sessions, and participant time associated with travel and using a mobile app. Health-related quality of life (HRQOL) was measured using the 5-level EuroQol 5-Dimension instrument (EQ-5D-5L) at baseline, immediately after the intervention period, and at 3 and 6 months.
Valuation of resources used standard sources: Medicare payments were applied to value medical resource utilization and therapist time. Patient time was monetized using the average US wage. The source reports that these inputs were combined to estimate costs for the mPCST and control groups and to calculate incremental cost-effectiveness metrics.
The analysis focused on preference-weighted EQ-5D-5L scores to derive quality-adjusted life years (QALYs) over the follow-up period and to compute the incremental cost-effectiveness ratio (ICER) comparing mPCST to control. Specific modeling details (for example, discounting, handling of missing data, or probabilistic sensitivity analysis methods) are not reported in the abstract and therefore are not available from the source provided.
Medical resource utilization was reported as similar between the mPCST and control groups overall, though hospitalizations trended higher in the mPCST group according to the abstract. Across the follow-up period, participants randomized to mPCST had higher preference-weighted EQ-5D-5L scores by an average of 0.066 (p = 0.04) compared with the control condition. This difference translated into an incremental gain of 0.04 QALYs (95% CI: 0.00–0.08) for mPCST over the follow-up horizon.
Cost components explicitly reported include a base-case program cost for mPCST of $500 compared with $0 for the control condition. Patient time costs were also estimated and, when included, added $303 to the mPCST arm in the analysis.
Using the reported base-case costs (mPCST = $500; control = $0) and the observed incremental QALY gain (0.04), the incremental cost-effectiveness ratio (ICER) for mPCST versus control was $12,725 per QALY (95% CI: 5,566–69,343).
When the value of patient time was included in the mPCST cost (an additional $303), the ICER increased to $20,438 per QALY (95% CI: 9,051–111,403). Confidence intervals reported with both ICER estimates reflect uncertainty in the incremental cost and effectiveness estimates as presented in the source.
The authors conclude that the virtually delivered pain coping skills training program (mPCST) is a cost-effective intervention that improves health-related quality of life for women with cancer living in medically underserved areas. Reported ICERs ($12,725 and $20,438 per QALY depending on whether patient time is included) fall well within commonly cited willingness-to-pay thresholds used in US-based economic evaluations, supporting the economic value of offering the program to this population as described in the trial.
The abstract reports key outcomes and summary economic results but does not provide all methodological or sample-specific details in the source text available here. Not reported in the abstract are the trial sample size and demographic composition, specific counts or rates for hospitalizations and other individual healthcare events, the precise timeframe for cost aggregation beyond the 6-month follow-up, or full analytic methods (for example, whether probabilistic sensitivity analysis or subgroup analyses were performed). These details would be found in the full-text article but are not available from the abstract provided.
Overall, based on the data reported in the source, mPCST delivered virtually in a 4-session format improved EQ-5D-5L preference weights and produced modest incremental costs relative to control, resulting in ICERs that the study authors interpret as demonstrating cost-effectiveness for women with cancer in medically underserved areas.