title: Economic analysis of psychosocial group therapy in women with metastatic breast cancer.
abstract: OBJECTIVE
  Metastatic breast cancer is associated with psychological distress in one-third of patients. We examined the impact of group psychosocial support on health care costs in metastatic breast cancer. Psychosocial interventions have been shown to reduce psychological distress in these patients. In other diseases, depression and anxiety have been associated with higher health care system resource utilization.
  
  
  METHODS
  Data on health care system resources utilization were collected as part of a Canadian multicenter randomized controlled trial of a supportive-expressive group support in metastatic breast cancer. Costs were obtained from one tertiary care hospital in Toronto. A cost minimization analysis was conducted since there was no survival difference; the primary endpoint of the study. Cost-effectiveness analyses were conducted for mood and pain.
  
  
  RESULTS
  Total health care utilization costs (including costs of the group therapy intervention) for the intervention and control groups were $31,715 and $28,189, respectively per patient. The difference in total costs between groups ($3,526) was not statistically significant (P = 0.53). The cost-effectiveness analysis for mood showed the intervention group to have an increased cost of $5,550 per patient for an effect size of 0.5 on the POMS scale. The corresponding cost for pain was $4,309. An exploratory analysis on patients who were more distressed at baseline showed a non-significant decrease in cost in favor of the intervention arm (difference of $3,911 P = 0.66).
  
  
  CONCLUSIONS
  Psychosocial intervention, in the form of supportive-expressive group support for metastatic breast cancer, does not lower health care system resource utilization.
authors.affiliation: Samuel Lunenfeld Research Institute of the Mount Sinai Hospital, University of Toronto, 1284-600 University Ave, M5G 1X5 Toronto, ON, Canada. lemieux@mshri.on.ca
authors.forename: Julie
authors.initials: J
authors.lastname: Lemieux
authors.forename: Adam
authors.initials: A
authors.lastname: Topp
authors.forename: Heather
authors.initials: H
authors.lastname: Chappell
authors.forename: Marguerite
authors.initials: M
authors.lastname: Ennis
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Goodwin
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011615:Psychotherapy, Group / Q000191:economics*; D012944:Social Support; D016896:Treatment Outcome