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

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.