4.6 Article

Economic evaluation of prostate cancer risk assessment methods: A cost-effectiveness analysis using population data

期刊

CANCER MEDICINE
卷 -, 期 -, 页码 -

出版社

WILEY
DOI: 10.1002/cam4.6587

关键词

economic evaluation; health administrative data; prostate cancer; screening

类别

向作者/读者索取更多资源

In this study, a modeling framework was constructed to evaluate the cost-effectiveness of using a new risk assessment tool (RAT) for biopsy decision-making in men with gray zone prostate-specific antigen (PSA) levels. The RAT based on an existing biomarker's characteristics was found to be a dominant strategy, resulting in cost savings and improved quality-adjusted life years (QALY) compared to the current standard of care (SOC). The findings suggest that implementing a more accurate RAT for biopsy guidance can be cost-effective.
BackgroundThe current prostate cancer (PCa) screening standard of care (SOC) leads to unnecessary biopsies and overtreatment because decisions are guided by prostate-specific antigen (PSA) levels, which have low specificity in the gray zone (3-10 ng/mL). New risk assessment tools (RATs) aim to improve biopsy decision-making. We constructed a modeling framework to assess new RATs in men with gray zone PSA from the British Columbia healthcare system's perspective.MethodsWe evaluated the cost-effectiveness of a new RAT used in biopsy-naive men aged 50+ with a PSA of 3-10 ng/mL using a time-dependent state-transition model. The model was informed by engaging patient partners and using linked administrative health data, supplemented with published literature. The incremental cost-effectiveness ratio and the probability of the RAT being cost-effective were calculated. Probabilistic analysis was used to assess parameter uncertainty.ResultsIn the base case, a RAT based on an existing biomarker's characteristics was a dominant strategy associated with a cost savings of $44 and a quality-adjusted life years (QALY) gain of 0.00253 over 18 years of follow-up. At a cost-effectiveness threshold of $50,000/QALY, the probability that using a RAT is cost-effective relative to the SOC was 73%. Outcomes were sensitive to RAT costs and accuracy, especially the detection rate of high-grade PCa. Results were also impacted by PCa prevalence and assumptions about undetected PCa survival.ConclusionsOur findings showed that a more accurate RAT to guide biopsy can be cost-effective. Our proposed general model can be used to analyze the cost-effectiveness of any novel RAT.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据