Cost Utility Analysis of a Digital Peer Navigation Program for Men With Prostate Cancer
Author(s)
Elizabeth Y. Yusuf, MSc1, Marie Lan, MSc2, Therese Servito, MD2, Peter C Coyte, PhD3, Arminee Kazanjian, PhD4, Robin Urquhart, PhD5, Rebecca Laura Hancock-Howard, PhD6, Jacqueline Lorene Bender, PhD3.
1Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada, 2University of Toronto, TORONTO, ON, Canada, 3University of Toronto, Toronto, ON, Canada, 4University of British Columbia, British Columbia, BC, Canada, 5Dalhousie University, Halifax, NS, Canada, 6Accessing Centre for Expertise, Toronto, ON, Canada.
1Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada, 2University of Toronto, TORONTO, ON, Canada, 3University of Toronto, Toronto, ON, Canada, 4University of British Columbia, British Columbia, BC, Canada, 5Dalhousie University, Halifax, NS, Canada, 6Accessing Centre for Expertise, Toronto, ON, Canada.
OBJECTIVES: The objective was to evaluate the cost-utility of the True North PN program compared to an active wait-list control arm of participants who do not have access to the peer navigation intervention from a healthcare payer perspective.
METHODS: A Markov model was developed comparing the two interventions. The model consisted of 4 patient activation levels (activation levels 1 - 4) and a death state. The time horizon was 2 years, this was selected as most side effects get resolved within this timeline with actie treatments, and the cycle length was 3 months. Transition probabilities and utilities were informed by an unpublished randomized controlled trial (ID: NCT05041504). Costs were obtained from program administrators and publicly available sources. One-way deterministic, scenario, and probabilistic sensitivity analyses were performed to evaluate uncertainty and test assumptions.
RESULTS: While True North PN was more costly ($4,882 vs. $4,565 per person), it yielded more QALYs (6.69 vs. 6.65) when compared to the control group, resulting in an ICER of $9,283 per QALY. The probability that True North Peer Navigation was cost-effective at a willingness-to-pay threshold (WTP) of $50,000/QALY was 55%. One-way sensitivity showed that utility values and costs for each state had the largest impact on the ICER.
CONCLUSIONS: A digital peer navigation program is cost-effective from a Canadian healthcare payer’s perspective at a WTP threshold of $50,000/QALY. Future research should explore how to successfully implement digital peer navigation into routine PC care.
METHODS: A Markov model was developed comparing the two interventions. The model consisted of 4 patient activation levels (activation levels 1 - 4) and a death state. The time horizon was 2 years, this was selected as most side effects get resolved within this timeline with actie treatments, and the cycle length was 3 months. Transition probabilities and utilities were informed by an unpublished randomized controlled trial (ID: NCT05041504). Costs were obtained from program administrators and publicly available sources. One-way deterministic, scenario, and probabilistic sensitivity analyses were performed to evaluate uncertainty and test assumptions.
RESULTS: While True North PN was more costly ($4,882 vs. $4,565 per person), it yielded more QALYs (6.69 vs. 6.65) when compared to the control group, resulting in an ICER of $9,283 per QALY. The probability that True North Peer Navigation was cost-effective at a willingness-to-pay threshold (WTP) of $50,000/QALY was 55%. One-way sensitivity showed that utility values and costs for each state had the largest impact on the ICER.
CONCLUSIONS: A digital peer navigation program is cost-effective from a Canadian healthcare payer’s perspective at a WTP threshold of $50,000/QALY. Future research should explore how to successfully implement digital peer navigation into routine PC care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE189
Topic
Economic Evaluation, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology