Cost-utility analysis of a web-based interactive patient education platform: evidence from a randomized clinical trial for end-stage renal disease patients
Year: 2025
Type: article
Abstract: OBJECTIVES: Chronic kidney disease and its most severe complication, end-stage renal disease (ESRD), represents an estimated financial burden of €4.4 billion in 2021 in France. Therapeutic patient education (TPE) improves ESRD management and health outcomes. This study explored whether providing access to an interactive web-based TPE platform with community features was cost-effective. METHODS: A within-trial cost-utility analysis was carried out over an 18 months horizon, using data from the PIC-R (Plateforme Interactive Communautaire-dialyse et transplantation Rénale) trial. ESRD or post-transplant patients were randomized 1:1:1 to a control group with no specific TPE program (Control), an intervention group with online TPE (e-TPE) and an intervention group with online TPE coupled with community features such as a patient forum and a chatroom with both patients and health care professionals (e-TPE + chat). The outcome measure was the cost per quality-adjusted life-year (QALY) and per year of full capability (YFC). Both intention-to-treat (ITT) and per protocol (PP) analyses were conducted, and missing data were handled using multiple imputation and selection models. Sensitivity analyses were performed. RESULTS: Among the 815 patients assessed for eligibility across 12 French centres, a total of 549 patients were included in the economic analysis: 186 in the Control group, 189 in the e-TPE group and 174 in the e-TPE + chat group. The e-TPE group demonstrated cost savings and slightly higher QALYs compared to the control group, making e-TPE dominant. Conversely, the e-TPE + chat intervention resulted in higher costs without substantial effectiveness gains, making it not cost-effective. CONCLUSIONS: e-TPE was deemed cost-effective for ESRD patients, while e-TPE + chat was not. Web-based platforms improve ESRD management when targeted to likely users.
Authors: Modou Diop, Lionel Perrier, Baptiste Haon, Lise Rochaix, Luc Behaghel, Jean-Claude K. Dupont, Magali Morelle, Michelle Elias, Laure Esposito, Christophe Legendre, Hélène Longuet, Isabelle Durand-Zaleski, Evangéline Pillebout, PIC-R trial Investigators, Benoit Barrou, Jean-Jacques Boffa, Arnaud Delbello, Gauthier Flahaut, Magali Giral, Caroline Gourraud-Vercel, Anne Grall-Jezequel, Aurélie Houzet-Meurette, Nassim Kamar, Yannick Le Meur, Camille Petit-Hoang, Eric Thervet, Leïla Tricot
Institutions: Assistance Publique – Hôpitaux de Paris, Hôtel-Dieu de Paris, Centre National de la Recherche Scientifique, Université Lumière Lyon 2, Centre Léon Bérard, Groupe d'Analyse et de Théorie Economique Lyon St Etienne, Université Jean Monnet, École de management de Lyon, Université Jean Monnet, Paris School of Economics, Inserm, Institut Pasteur, Université Paris Cité, Sorbonne Université, Centre de Recherche des Cordeliers, Bicêtre Hospital, Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, Hôpital Necker-Enfants Malades, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Hôpital Saint-Louis
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Award: G4307440039
OpenAlex ID: W4414514501