The Cost-Effectiveness of a Novel Scalp Cooling Device to Alleviate Chemotherapy-Induced Alopecia in Patients With Early Breast Cancer
Author(s)
Yanting Ouyang, MPH1, Yiying Cai, PhD1, Eileen Yi Ling Poon, MBBS, MRCP(UK), M MED (Internal Medicine)2, Sherilyn Zi Hui Liew, MBBS2, Nicholas Graves, PhD1.
1Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore, 2National Cancer Centre Singapore, Singapore, Singapore.
1Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore, 2National Cancer Centre Singapore, Singapore, Singapore.
OBJECTIVES: Chemotherapy-induced alopecia is a common side effect with significant psychological impacts, affecting patients' quality of life. Up to 14% of patients may decline chemotherapy due to concerns over hair loss. While automated scalp cooling systems and manual cold caps can reduce alopecia, logistical constraints—including space, staffing, and extended chair time—limit their availability at Singapore’s largest tertiary cancer centre. To overcome this, a team of oncologists co-developed a novel scalp cooling cap (“Product X”) in collaboration with a Singapore-based MedTech company. It is portable and allows patients to leave the treatment chair immediately after chemotherapy. This early cost-effectiveness analysis evaluated the potential value of adopting Product X versus current practice (no scalp cooling).
METHODS: We developed a decision-analytic model comprising a decision tree and a lifetime Markov model to estimate the costs and health outcomes for female patients with early breast cancer, from a health system perspective. The model incorporated costs related to scalp cooling equipment and administration, chemotherapy, and treatment for cancer recurrence. Assumptions regarding Product X’s efficacy and its potential impact on chemotherapy compliance were tested in nine scenario analyses (efficacy: 50%, 75%, 100%; compliance improvement: 0, 1%, 5%). Probabilistic scenario analysis with 1,000 simulations was conducting using appropriate parameter distributions.
RESULTS: In the base case (1% improvement in compliance and 100% efficacy), Product X yielded an incremental cost of S$265 per patient (95% UI: S$251 - S$281) and incremental quality-adjusted life years (QALY) of 0.0717 (95% UI: 0.0705 - 0.0729). At willing-to-pay of S$45,000 per QALY, incremental net monetary benefits (INMB) was S$2,961 (95% UI: S$2,906 - S$3,015), with a 100% probability of cost-effectiveness. Across scenarios, INMB ranged from S$1,158 to S$3,330.
CONCLUSIONS: Scenario and probabilistic analyses suggest that Product X is a cost-effective solution for chemotherapy-induced alopecia, supporting its adoption from a health system perspective.
METHODS: We developed a decision-analytic model comprising a decision tree and a lifetime Markov model to estimate the costs and health outcomes for female patients with early breast cancer, from a health system perspective. The model incorporated costs related to scalp cooling equipment and administration, chemotherapy, and treatment for cancer recurrence. Assumptions regarding Product X’s efficacy and its potential impact on chemotherapy compliance were tested in nine scenario analyses (efficacy: 50%, 75%, 100%; compliance improvement: 0, 1%, 5%). Probabilistic scenario analysis with 1,000 simulations was conducting using appropriate parameter distributions.
RESULTS: In the base case (1% improvement in compliance and 100% efficacy), Product X yielded an incremental cost of S$265 per patient (95% UI: S$251 - S$281) and incremental quality-adjusted life years (QALY) of 0.0717 (95% UI: 0.0705 - 0.0729). At willing-to-pay of S$45,000 per QALY, incremental net monetary benefits (INMB) was S$2,961 (95% UI: S$2,906 - S$3,015), with a 100% probability of cost-effectiveness. Across scenarios, INMB ranged from S$1,158 to S$3,330.
CONCLUSIONS: Scenario and probabilistic analyses suggest that Product X is a cost-effective solution for chemotherapy-induced alopecia, supporting its adoption from a health system perspective.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE691
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology