Remote Monitoring App May Offer Lower Costs During Breast Cancer Endocrine Therapy

This economic evaluation used data from the THRIVE trial, which randomized 304 women initiating adjuvant endocrine therapy for early-stage breast cancer to an app, an app with tailored feedback, or enhanced usual care. The interventions lasted six months, with 12 months of follow-up. Costs were assessed from a societal perspective, and quality-adjusted life years (QALYs) were estimated from patient-reported health-status scores. Complete data were available for 214 participants; their mean age was 58.9 years.

Mean total costs were $6,682 for app-only monitoring, $11,408 for the app with tailored feedback, and $11,596 for enhanced usual care. Estimated QALYs were similar across groups, ranging from 0.78 to 0.79. At a willingness-to-pay threshold of $100,000 per QALY, the incremental net monetary benefit was $5,814 for app-only monitoring and $88 for the app with feedback. Probabilistic analyses estimated a 68.2% to 78.1% probability that app-only monitoring was cost-effective across thresholds of $0 to $200,000 per QALY; corresponding estimates for the feedback arm were 53.6% to 70.8%.

The findings suggest potential economic value for app-only monitoring, but uncertainty intervals were wide and the analysis included fewer than the 304 randomized participants. The results do not establish improved adherence or clinical outcomes, and the authors’ proposed scalability advantage was not demonstrated as a clinical outcome.