Cost-utility analysis of a web-based interactive patient education platform: evidence from a randomized clinical trial for end-stage renal disease patients

Modou Diop, Lionel Perrier (), Baptiste Haon, Lise Rochaix (), Luc Behaghel, Jean-Claude Dupont, Magali Morelle (), Michelle Elias, Laure Esposito, Christophe Legendre, Hélène Longuet, Isabelle Durand-Zaleski, Evangéline Pillebout, Benoit Barrou, Jean-Jacques Boffa, Arnaud Delbello, Gauthier Flahaut, Magali Giral (), Caroline Gourraud-Vercel, Anne Grall-Jezequel, Aurélie Houzet-Meurette, Nassim Kamar, Yannick Le Meur, Camille Petit-Hoang, Eric Thervet and Leïla Tricot
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Modou Diop: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Lionel Perrier: GATE Lyon Saint-Étienne - Groupe d'Analyse et de Théorie Economique Lyon - Saint-Etienne - UL2 - Université Lumière - Lyon 2 - UJM - Université Jean Monnet - Saint-Étienne - EM - EMLyon Business School - CNRS - Centre National de la Recherche Scientifique, Centre Léon Bérard [Lyon]
Baptiste Haon: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Lise Rochaix: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Jean-Claude Dupont: Direction juridique [Institut Pasteur] - IP - Institut Pasteur [Paris] - UPCité - Université Paris Cité, ETRES - Éthique, recherches, translations = Ethics, research, translations [CRC] - CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers - EPHE - École Pratique des Hautes Études - PSL - Université Paris Sciences et Lettres - INSERM - Institut National de la Santé et de la Recherche Médicale - SU - Sorbonne Université - UPCité - Université Paris Cité
Magali Morelle: GATE - Health System Analysis Laboratory - Université de Lyon, GATE Lyon Saint-Étienne - Groupe d'Analyse et de Théorie Economique Lyon - Saint-Etienne - UL2 - Université Lumière - Lyon 2 - UJM - Université Jean Monnet - Saint-Étienne - EM - EMLyon Business School - CNRS - Centre National de la Recherche Scientifique
Michelle Elias: Néphrologie [CHU Bicêtre] - Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Laure Esposito: Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
Christophe Legendre: Département de Néphrologie [CHU Necker] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Hélène Longuet: CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
Isabelle Durand-Zaleski: UPCité - Université Paris Cité, URC Eco - Unité de Recherche Clinique en Economie de la Santé d'Ile-de-France - Hôpital Hôtel-Dieu [Paris] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Evangéline Pillebout: AP-HP - Hopital Saint-Louis [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)

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Abstract: Objectives: Chronic kidney disease and its most severe complication, end-stage renal disease (ESRD), represents an estimated financial burden of €4.4 billion in 2021 in France. Therapeutic patient education (TPE) improves ESRD management and health outcomes. This study explored whether providing access to an interactive web-based TPE platform with community features was cost-effective. Methods: A within-trial cost-utility analysis was carried out over an 18 months horizon, using data from the PIC-R (Plateforme Interactive Communautaire—dialyse et transplantation Rénale) trial. ESRD or post-transplant patients were randomized 1:1:1 to a control group with no specific TPE program (Control), an intervention group with online TPE (e-TPE) and an intervention group with online TPE coupled with community features such as a patient forum and a chatroom with both patients and health care professionals (e-TPE + chat). The outcome measure was the cost per quality-adjusted life-year (QALY) and per year of full capability (YFC). Both intention-to-treat (ITT) and per protocol (PP) analyses were conducted, and missing data were handled using multiple imputation and selection models. Sensitivity analyses were performed. Results: Among the 815 patients assessed for eligibility across 12 French centres, a total of 549 patients were included in the economic analysis: 186 in the Control group, 189 in the e-TPE group and 174 in the e-TPE + chat group. The e-TPE group demonstrated cost savings and slightly higher QALYs compared to the control group, making e-TPE dominant. Conversely, the e-TPE + chat intervention resulted in higher costs without substantial effectiveness gains, making it not cost-effective. Conclusions: e-TPE was deemed cost-effective for ESRD patients, while e-TPE + chat was not. Web-based platforms improve ESRD management when targeted to likely users.

Keywords: Cost-effectiveness analysis; Cost-utility analysis; End-stage renal disease; Patient therapeutic education; Randomized clinical trial; Web-based intervention (search for similar items in EconPapers)
Date: 2025
Note: View the original document on HAL open archive server: https://hal.science/hal-05307888v1
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Published in European Journal of Health Economics, In press, ⟨10.1007/s10198-025-01828-w⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-05307888

DOI: 10.1007/s10198-025-01828-w

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