Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

ePROMs in routine cancer care: are they worth the investment? a cost-effectiveness analysis (146085)

Dan Lindsay 1 2 3 , Ureni Halahakone 1 , Ingrid Rowlands 2 3 , Amy Brown 4 , Bena Brown 3 5 6 , Fiona Crawford-Williams 7 , Melissa Eastgate 8 9 , Afaf Girgis 10 , Gunter Hartel 2 3 11 12 , Rahul Ladwa 3 5 , Robert Mason 13 , Peter McGuire 8 , Elizabeth Miller 5 14 , Rebecca Packer 3 , Sabe Sabesan 4 15 , Jasotha Sanmugarajah 13 16 , Doreen Tapsall 5 , Laurelie Wishart 3 5 11 , David Wyld 3 8 11 , Raymond Chan 7 , Penelope Webb 2 3 , Louisa Collins 1 3 9
  1. Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
  2. Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
  3. Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
  4. Townsville Cancer Centre, Townsville University Hospital, Townsville, Queensland, Australia
  5. Division of Cancer Care Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  6. Southern Queensland Centre for Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, , Metro South Health, Brisbane, Queensland, Australia
  7. LiveWell Cancer Research Centre, College of Health and Enablement, Flinders University, Bedford Park, Adelaide, South Australia, Australia
  8. Cancer Care Services, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
  9. Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
  10. UNSW Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
  11. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  12. Griffith Institute for Biomedicine and Glycomics, , Griffith University, Brisbane, Queensland, Australia
  13. Gold Coast University Hospital, Gold Coast, Queensland, Australia
  14. Consumer partner, Metro South, Brisbane, Queensland, Australia
  15. College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
  16. School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia

Aim: To undertake an economic evaluation on the routine use of electronic patient‑reported outcome measures (ePROMs) using data from a pragmatic, multi-site, hybrid effectiveness and implementation trial (PROMISE). We tested if health system costs, in relation to quality of life, were improved for patients and whether unplanned hospitalisations were avoided through ePROMs.

Methods: A cost-effectiveness analysis was undertaken using data from PROMISE (n=538), a trial comparing ePROM use during cancer treatment versus usual care. Health system costs and outcomes were quantified and compared across the two options over six months. Data were collected on participant surveys, hospital medical records and via administrative healthcare claims. The primary outcome was net monetary benefits (NMBs) using a willingness-to-pay threshold of AU$50,000 and quality-adjusted life years (QALYs). Positive NMBs are interpreted as the ePROMs having favourable cost-effectiveness. 95% confidence intervals (CIs) around NMBs were generated through the bootstrap percentile method using 1,000 bootstrap replications. Sensitivity analyses using a per-protocol approach and threshold analyses were completed.

Results: Over 6 months, similar healthcare costs were seen for the intervention group (~$54,000) and usual care (~$52,000). There were no significant differences in mean QALYs for the intervention and usual care groups. Mean NMBs were small but positive from the health system (~$2,500), state government and individual cost perspectives however 95% CIs spanned zero, indicating no clear economic benefit. The likelihood that ePROMs was cost-effective as implemented here was approximately 45%. Unplanned hospitalisations were also similar across the two groups.

Conclusions: These preliminary finding indicate that as incremental differences in costs and QALYs were negligible, using ePROMs or not resulted in comparable costs and health outcomes. Nevertheless, the ePROMs intervention demonstrated benefits on other health outcomes, which should be considered when determining overall value and potential contribution to patient care.