The Ambulatory Medical Assistance (AMA) programme during active‐phase treatment in patients with haematological malignancies: A cost‐effectiveness analysis

Abstract

Context The need for patient navigator is growing, and there is a lack of cost evaluation, especially during survivorship. Objective The objective of this study is to evaluate the cost‐effectiveness of an Ambulatory Medical Assistance (AMA) programme in patients with haematological malignancies (HM). Design A cost‐effectiveness analysis of the AMA programme was performed compared to a simulated control arm. Setting An interventional, single‐arm and prospective study was conducted in a French reference haematology–oncology centre between 2016 and 2020. Participants Adult patients were enrolled with histologically documented malignant haematology, during their active therapy phase, and treated either by intravenous chemotherapy or oral therapy. Methods An extrapolation of the effectiveness was derived from a similar nurse monitoring programme (CAPRI study). Cost effectiveness of the programme was evaluated through adverse events of Grade 3 or 4 avoided in different populations. Results Included patient (n = 797) from the AMA programme were followed during 125 days (IQR: 0–181), and adverse events (Grade 3/4) were observed in 10.1% of patients versus 13.4% in the simulated control arm. The overall cost of AE avoided was estimated to €81,113, leading to an ICER of €864. Conclusion The AMA programme was shown to be cost‐effective compared to a simulated control arm with no intervention.

Retrospective, real‐life study of venetoclax plus azacitidine or low‐dose cytarabine in French patients with acute myeloid leukemia ineligible for intensive chemotherapy

“… 19 During active‐phase treatment in patients with hematologic malignancies, the AMA program was demonstrated to ensure safe care through avoidance of adverse events (hematologic or nonhematologic). 20 Patients with AML treated with new molecules are thus good candidates for an AMA program.…”

“…First developed in France for lymphoid disease, ambulatory medical assistance (AMA) is a multidisciplinary program that uses phone calls from nurses to monitor patients who are undergoing active home treatment 19 . During active‐phase treatment in patients with hematologic malignancies, the AMA program was demonstrated to ensure safe care through avoidance of adverse events (hematologic or nonhematologic) 20 . Patients with AML treated with new molecules are thus good candidates for an AMA program.…”