OBJECTIVES: The aim of the study was the economic evaluation of an ehealth application that fosters palliative care for cancer patients in Greece.

METHODS: The sample of the analysis consisted of patients with chronic lymphocytic leukaemia or myelodysplastic syndrome, who participated, in 2 Greek hospitals, in the European randomised clinical trial MyPal-ADULT. The intervention group had access to the MyPal digital app and a smart watch, while the control group received standard palliative care. Patients' quality of life was measured with the EQ-5D-3L questionnaire every 4 weeks for a total of 6 months, and converted to Quality Adjusted Life Years (QALYs). Costs included the use of healthcare resources, healthcare professionals' time (education-engagement) and the smart watch. The analysis was performed from a third-party payer perspective with 2023 as the reference year. Cost data were sought from appropriate official sources. The Incremental Cost-Utility Ratio (ICUR) was estimated and a non-parametric sensitivity analysis was performed.

RESULTS: Overall, 48 patients - 21 in the intervention and 27 in the control group - had adequate data on quality of life and costs and, thus, were used in the analysis. At 6 months, Quality-Adjusted Life Years (QALYs) in the intervention group were estimated at 0.403 (95%CI=0.368;0.437) and in the control group at 0.391 (95%CI=0.354;0.427). Similarly, the mean total cost per patient of the intervention group was 1,380.82€ (95%CI=1,014.72;1,746.92) and of the control group 870.32€ (95%CI=440.70;1,299.93). A significant contributor in the intervention group higher costs was the time of the healthcare professionals. ICUR was estimated at 41,642.94€/QALY, and sensitivity analysis showed that, in the majority of cases, the intervention has higher costs and higher effectiveness than usual care.

CONCLUSIONS: The ehealth intervention is more costly and slightly more effective than usual care. Standardization of major cost categories, such as training of healthcare professionals, can help improve the cost-effectiveness of the intervention.