The cost-effectiveness of a nurse-led care program for breast cancer patients undergoing outpatient-based chemotherapy – A feasibility trial

Xiao Bin Lai, Shirley Siu Yin Ching, Frances Kam Yuet Wong, Carenx Wai Yee Leung, Lai Ha Lee, Jessica Shuk Yin Wong, Yim Fan Lo

Research output: Journal article publicationJournal articleAcademic researchpeer-review

5 Citations (Scopus)


Purpose: To evaluate the cost-effectiveness of a nurse-led care program for breast cancer patients receiving outpatient-based chemotherapy. Method: An open-label, single-center randomized controlled trial was conducted. Patients receiving the nurse-led care and those receiving the routine care were compared in terms of quality of life, as well as in health service utilizations and total cost of care. A cost-utility analysis was conducted. Results: A total of 124 patients were recruited. The data of 116 subjects who completed the study were used for the cost-utility analysis. There were 81 unscheduled hospital visits and 43 hospital admissions. The common reasons for utilizing health services were infections and fevers, skin problems, digestive system problems, and mouth/teeth/throat problems. There were no differences in health service utilizations between the nurse-led and routine care groups for subjects receiving four-cycle chemotherapy. For those receiving six-cycle chemotherapy, the estimated number of emergency department visits was 2.188 times (95% Confidence Interval, 1.051 to 4.554) higher for the routine care group when compared with the nurse-led care group (p =.038). The incremental cost-utility ratios were £8856 and £18,936 per quality-adjusted life year gained for subjects receiving four-cycle and six-cycle chemotherapy, respectively. Conclusions: Cancer patients make unscheduled health service visits when receiving outpatient-based chemotherapy, which leads to increased health service costs. The nurse-led care reduces emergency departments visits made by breast cancer patients undergoing six-cycle adjuvant chemotherapy. For breast cancer patients undergoing four-cycle chemotherapy and six-cycle chemotherapy, the nurse-led care could be cost-effective.

Original languageEnglish
Pages (from-to)16-25
Number of pages10
JournalEuropean Journal of Oncology Nursing
Publication statusPublished - Oct 2018


  • Advanced practice nursing
  • Breast neoplasms
  • Chemotherapy
  • Economics

ASJC Scopus subject areas

  • Oncology(nursing)

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