Economic Evaluation and development of a Prediction Tool for Implementing a Survivorship Passport

Background

Across Europe, more than 80% of children and adolescents diagnosed with cancer survive, yet survivorship care remains fragmented and inequitable. Inconsistent follow‑up increases the risk of preventable late effects. The EU‑funded PanCareSurPass project addresses this challenge by implementing SurPass, a digital survivorship passport supporting guideline‑based, person‑centred follow‑up care. This study evaluates the value of SurPass and develops a decision‑support model to inform implementation across health systems.

Methods

A multicountry health economic evaluation was conducted in survivorship clinics in six European countries. Cost‑utility analyses (CUA) compared SurPass with standard care over 5‑, 10‑, and 20‑year horizons. QALYs were estimated using the EQ‑5D‑5L(Y), with long‑term effects informed by the St. Jude Lifetime Cohort Study. Costs included implementation, operational, survivor, and healthcare costs. A multi‑criteria decision analysis (MCDA) captured broader outcomes, including patient activation, empowerment, and perceived usefulness. Results were integrated into a prediction model that enables scenario‑based assessments of value under differing national contexts, scale‑up assumptions, and levels of digital maturity.

Results

CUA demonstrated short‑term cost‑effectiveness in a subset of clinics. Cost‑effectiveness improved consistently over longer horizons. MCDA results consistently favoured SurPass, even where QALY‑based findings were inconclusive. The prediction model was made publicly available as part of an implementation toolkit.

Conclusions

SurPass represents a high‑value, innovative approach to improving childhood cancer survivorship care. The combined use of CUA, MCDA, and a prediction model provides actionable evidence for policymakers, supporting informed investment decisions. Integration into electronic health records and automation of operational processes are recommended to maximise long‑term public health impact.

Key messages

• The SurPass improves equality, quality of childhood cancer survivorship care as well as patient empowerment.

• With the prediction model, the project enables evidence‑based decisions on implementing the SurPass in European health systems.