Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial

Femke Jansen; Veerle M H Coupé; Simone E J Eerenstein; Ingrid C Cnossen; Cornelia F van Uden-Kraan; Remco de Bree; Patricia Doornaert; György B Halmos; José A U Hardillo; Gerben van Hinte; Jimmie Honings; C René Leemans; Irma M Verdonck-de Leeuw

doi:10.1016/j.oraloncology.2021.105306

Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial

Femke Jansen^*, Veerle M H Coupé, Simone E J Eerenstein, Ingrid C Cnossen, Cornelia F van Uden-Kraan, Remco de Bree, Patricia Doornaert, György B Halmos, José A U Hardillo, Gerben van Hinte, Jimmie Honings, C René Leemans, Irma M Verdonck-de Leeuw

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVES: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC.

MATERIALS AND METHODS: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping.

RESULTS: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale).

CONCLUSION: ITwC is likely to be effective, but possibly at higher expenses.

TRIAL REGISTRATION: NTR5255.

Original language	English
Article number	105306
Number of pages	9
Journal	Oral Oncology
Volume	117
Early online date	24-Apr-2021
DOIs	https://doi.org/10.1016/j.oraloncology.2021.105306
Publication status	Published - Jun-2021

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Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy Results of a multi-center randomized controlled trialFinal publisher's version, 1.08 MBLicence: CC BY

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Jansen, F., Coupé, V. M. H., Eerenstein, S. E. J., Cnossen, I. C., van Uden-Kraan, C. F., de Bree, R., Doornaert, P., Halmos, G. B., Hardillo, J. A. U., van Hinte, G., Honings, J., Leemans, C. R., & Verdonck-de Leeuw, I. M. (2021). Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial. Oral Oncology, 117, Article 105306. https://doi.org/10.1016/j.oraloncology.2021.105306

@article{b705a45ca2e341fabffc91a7f4e1402f,

title = "Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial",

abstract = "OBJECTIVES: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC.MATERIALS AND METHODS: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping.RESULTS: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale).CONCLUSION: ITwC is likely to be effective, but possibly at higher expenses.TRIAL REGISTRATION: NTR5255.",

author = "Femke Jansen and Coup{\'e}, {Veerle M H} and Eerenstein, {Simone E J} and Cnossen, {Ingrid C} and {van Uden-Kraan}, {Cornelia F} and {de Bree}, Remco and Patricia Doornaert and Halmos, {Gy{\"o}rgy B} and Hardillo, {Jos{\'e} A U} and {van Hinte}, Gerben and Jimmie Honings and Leemans, {C Ren{\'e}} and {Verdonck-de Leeuw}, {Irma M}",

year = "2021",

month = jun,

doi = "10.1016/j.oraloncology.2021.105306",

language = "English",

volume = "117",

journal = "Oral Oncology",

issn = "1368-8375",

publisher = "ELSEVIER SCIENCE BV",

}

Jansen, F, Coupé, VMH, Eerenstein, SEJ, Cnossen, IC, van Uden-Kraan, CF, de Bree, R, Doornaert, P, Halmos, GB, Hardillo, JAU, van Hinte, G, Honings, J, Leemans, CR & Verdonck-de Leeuw, IM 2021, 'Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial', Oral Oncology, vol. 117, 105306. https://doi.org/10.1016/j.oraloncology.2021.105306

Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial. / Jansen, Femke; Coupé, Veerle M H; Eerenstein, Simone E J et al.
In: Oral Oncology, Vol. 117, 105306, 06.2021.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy

T2 - Results of a multi-center randomized controlled trial

AU - Jansen, Femke

AU - Coupé, Veerle M H

AU - Eerenstein, Simone E J

AU - Cnossen, Ingrid C

AU - van Uden-Kraan, Cornelia F

AU - de Bree, Remco

AU - Doornaert, Patricia

AU - Halmos, György B

AU - Hardillo, José A U

AU - van Hinte, Gerben

AU - Honings, Jimmie

AU - Leemans, C René

AU - Verdonck-de Leeuw, Irma M

PY - 2021/6

Y1 - 2021/6

N2 - OBJECTIVES: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC.MATERIALS AND METHODS: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping.RESULTS: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale).CONCLUSION: ITwC is likely to be effective, but possibly at higher expenses.TRIAL REGISTRATION: NTR5255.

AB - OBJECTIVES: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC.MATERIALS AND METHODS: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping.RESULTS: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale).CONCLUSION: ITwC is likely to be effective, but possibly at higher expenses.TRIAL REGISTRATION: NTR5255.

U2 - 10.1016/j.oraloncology.2021.105306

DO - 10.1016/j.oraloncology.2021.105306

M3 - Article

C2 - 33905913

SN - 1368-8375

VL - 117

JO - Oral Oncology

JF - Oral Oncology

M1 - 105306

ER -

Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial

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