Dataset Information

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

ABSTRACT:

Background

The 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.

Methods

We evaluated the cost-effectiveness of a new RAT used in biopsy-naïve 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.

Results

In 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.

Conclusions

Our 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.

SUBMITTER: Mohammadi T

PROVIDER: S-EPMC10587968 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

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

Mohammadi Tima T Guh Daphne P DP Tam Alexander C T ACT Pataky Reka E RE Black Peter C PC So Alan A Lynd Larry D LD Zhang Wei W Conklin Annalijn I AI

Cancer medicine 20230923 19

<h4>Background</h4>The 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.<h4>Methods</h4>We evalua ...[more]

PMID: 37740609

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Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

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