Cost-Utility Analysis of a Group Mindfulness Program Compared to an Education Support Program for Breast Cancer Survivors With Cognitive Impairment: Evidence From a Randomized Controlled Trial.
Hongdao Meng, Cecile A Lengacher, Rio Tate, Carmen Rodríguez, Kevin E Kip, Jong Y Park, Gizem Hueluer, Anh Thy Nguyen, Sandra Morgan, Sara Tinsley, Britney Veal, Anisha Joshi, Mahathi Krothapalli, Sreenidhi Nidamanur, Charles Cox, Lynne S Padgett, Manolete Moscoso, Elizabeth Bornstein, Jean M Lucas, Tamela Fonseca, Kristine A Donovan, Ramya Chamkeri, Richard R Reich
Psycho-oncology July 1, 2025 DOI: 10.1002/pon.70220
Summary
Mindfulness-based stress reduction (MBSR) for breast cancer survivors is not only effective but also cost-saving. In a study involving 181 participants, MBSR costs averaged $5,744, compared to $6,140 for traditional education support. Over six months, MBSR yielded an incremental cost of -$541 and improved quality of life by 0.021 quality-adjusted life years (QALY). The analysis indicated that MBSR likely achieves positive net monetary benefits, mainly due to reduced emergency room visits and hospital admissions, positioning it as a cost-effective option in health economics.
Abstract
To conduct an economic evaluation of a group mindfulness program compared to an education support program for breast cancer survivors (BCS). The cost-utility analysis (cost per quality-adjusted life year [QALY]) was performed from a single-center randomized controlled trial in the United States. Data from 181 BCS were included in the analysis (91 from the mindfulness-based stress reduction for breast cancer, MBSR(BC) and 90 from the Breast Cancer Education Support, (BCES)). Analyses were conducted from two perspectives: societal and healthcare system. The EuroQol EQ-5D-5L was used to measure quality of life and the Client Service Receipt Inventory (CSRI) was used to measure health services utilization from baseline through 26 weeks. The impact of MBSR(BC) on health services utilization and costs was estimated with generalized linear models. In the reference case analyses (societal perspective), the average total cost in the MBSR(BC) group was $5744 compared with $6140 in the BCES group. At the end of follow-up, the MBSR(BC) group dominated BCES in terms of Incremental Cost Utility Ratio (ICUR), with MBSR(BC) providing an incremental cost of -$541 (95% CI: -$3400, $2318) and a 0.021 QALY (95% CI: -0.014, 0.055). Net monetary benefit (NMB) analysis showed that MBSR(BC) has a higher probability of achieving positive NMB across a range of possible societal willingness-to-pay for improving quality of life. Our findings suggest that MBSR(BC) is likely to be cost-effective for breast cancer survivors over 6 months. Cost savings primarily resulted from reduced ER and hospital admissions and tests.