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Effectiveness and cost-effectiveness of prognostic markers in prostate cancer
This paper demonstrates how economic modelling can be used to derive estimates of the cost-effectiveness of prognostic markers in the management of clinically localised and moderately graded prostate cancer. The model uses a Markov process and is populated using published evidence and local data. Th...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2003
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376796/ https://www.ncbi.nlm.nih.gov/pubmed/12556955 http://dx.doi.org/10.1038/sj.bjc.6600630 |
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author | Calvert, N W Morgan, A B Catto, J W F Hamdy, F C Akehurst, R L Mouncey, P Paisley, S |
author_facet | Calvert, N W Morgan, A B Catto, J W F Hamdy, F C Akehurst, R L Mouncey, P Paisley, S |
author_sort | Calvert, N W |
collection | PubMed |
description | This paper demonstrates how economic modelling can be used to derive estimates of the cost-effectiveness of prognostic markers in the management of clinically localised and moderately graded prostate cancer. The model uses a Markov process and is populated using published evidence and local data. The robustness of the results has been tested using sensitivity analysis. Three treatment policies of ‘monitoring’ (observation), radical prostatectomy, or a selection-based management policy using DNA-ploidy as an experimental marker, have been evaluated. Modelling indicates that a policy of managing these tumours utilising experimental markers has an estimated cost per quality-adjusted life year (QALY) of £12 068. Sensitivity analysis shows the results to be relatively sensitive to quality-of-life variables. If novel and experimental markers can achieve specificity in excess of 80%, then a policy of radical surgery for those identified as being at high risk and conservative treatment for the remainder would be both better for patients and cost-effective. The analysis suggests that a radical prostatectomy treatment policy for the moderately graded tumours (Gleason grades –7) modelled in this paper may be inferior to a conservative approach in the absence of reliable prognostic markers, being both more costly and yielding fewer QALYs. |
format | Text |
id | pubmed-2376796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2003 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-23767962009-09-10 Effectiveness and cost-effectiveness of prognostic markers in prostate cancer Calvert, N W Morgan, A B Catto, J W F Hamdy, F C Akehurst, R L Mouncey, P Paisley, S Br J Cancer Clinical This paper demonstrates how economic modelling can be used to derive estimates of the cost-effectiveness of prognostic markers in the management of clinically localised and moderately graded prostate cancer. The model uses a Markov process and is populated using published evidence and local data. The robustness of the results has been tested using sensitivity analysis. Three treatment policies of ‘monitoring’ (observation), radical prostatectomy, or a selection-based management policy using DNA-ploidy as an experimental marker, have been evaluated. Modelling indicates that a policy of managing these tumours utilising experimental markers has an estimated cost per quality-adjusted life year (QALY) of £12 068. Sensitivity analysis shows the results to be relatively sensitive to quality-of-life variables. If novel and experimental markers can achieve specificity in excess of 80%, then a policy of radical surgery for those identified as being at high risk and conservative treatment for the remainder would be both better for patients and cost-effective. The analysis suggests that a radical prostatectomy treatment policy for the moderately graded tumours (Gleason grades –7) modelled in this paper may be inferior to a conservative approach in the absence of reliable prognostic markers, being both more costly and yielding fewer QALYs. Nature Publishing Group 2003-01-13 2003-01-28 /pmc/articles/PMC2376796/ /pubmed/12556955 http://dx.doi.org/10.1038/sj.bjc.6600630 Text en Copyright © 2003 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Calvert, N W Morgan, A B Catto, J W F Hamdy, F C Akehurst, R L Mouncey, P Paisley, S Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title | Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title_full | Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title_fullStr | Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title_full_unstemmed | Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title_short | Effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
title_sort | effectiveness and cost-effectiveness of prognostic markers in prostate cancer |
topic | Clinical |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376796/ https://www.ncbi.nlm.nih.gov/pubmed/12556955 http://dx.doi.org/10.1038/sj.bjc.6600630 |
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