Efficacy and medical cost offset of psychosocial interventions in cancer care: Making the case for economic analyses

The burden of cancer in the worldwide context continues to grow, as incidence and mortality increase each year. Regardless of where they live, a significant proportion of cancer patients at all stages of the disease trajectory will suffer social, emotional and psychological morbidity as a result of their diagnosis and treatment. Psychosocial interventions have proven efficacious in helping patients and families overcome many of the challenges that arise consequent to a cancer diagnosis. Addressing psychosocial needs is an essential aspect of any model of adequate cancer care, however it may also prove to be a cornerstone in efforts to extend the reach of cost-effective cancer treatment to meet the growing global need. In order to set the stage for discussion of economic issues, this paper first briefly reviews the literature detailing the extent of distress and the efficacy of psychosocial treatments for cancer patients. This is followed by a summary of terminology and costing concepts in the economic evaluation of psychosocial treatments, and a review of the literature on medical cost offset in mental health, other medical populations, and in cancer patients. The literature clearly supports the notion that psychosocial interventions are not only effective, but also economical. Conclusions support adding costing data into evaluations of the efficacy of psychosocial treatments in order to detail the often present but usually overlooked long-term cost savings that may be accrued to overburdened health-care systems. Copyright (C) 2004 John Wiley Sons, Ltd.