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A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer
The optimal management of patients with oligorecurrent prostate cancer (PCa) is unknown. There is growing interest in metastasis-directed therapy (MDT) for this population. The objective was to assess cost-utility from a Belgian healthcare payer’s perspective of MDT and delayed androgen deprivation...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016808/ https://www.ncbi.nlm.nih.gov/pubmed/31947974 http://dx.doi.org/10.3390/cancers12010132 |
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author | De Bleser, Elise Willems, Ruben Decaestecker, Karel Annemans, Lieven De Bruycker, Aurélie Fonteyne, Valérie Lumen, Nicolaas Ameye, Filip Billiet, Ignace Joniau, Steven De Meerleer, Gert Ost, Piet Bultijnck, Renée |
author_facet | De Bleser, Elise Willems, Ruben Decaestecker, Karel Annemans, Lieven De Bruycker, Aurélie Fonteyne, Valérie Lumen, Nicolaas Ameye, Filip Billiet, Ignace Joniau, Steven De Meerleer, Gert Ost, Piet Bultijnck, Renée |
author_sort | De Bleser, Elise |
collection | PubMed |
description | The optimal management of patients with oligorecurrent prostate cancer (PCa) is unknown. There is growing interest in metastasis-directed therapy (MDT) for this population. The objective was to assess cost-utility from a Belgian healthcare payer’s perspective of MDT and delayed androgen deprivation therapy (ADT) in comparison with surveillance and delayed ADT, and with immediate ADT. A Markov decision-analytic trial-based model was developed, projecting the results over a 5-year time horizon with one-month cycles. Clinical data were derived from the STOMP trial and literature. Treatment costs were derived from official government documents. Probabilistic sensitivity analyses showed that MDT is cost-effective compared to surveillance (ICER: €8393/quality adjusted life year (QALY)) and immediate ADT (dominant strategy). The ICER is most sensitive to utilities in the different health states and the first month MDT cost. At a willingness-to-pay threshold of €40,000 per QALY, the cost of the first month MDT should not exceed €8136 to be cost-effective compared to surveillance. The Markov-model suggests that MDT for oligorecurrent PCa is potentially cost-effective in comparison with surveillance and delayed ADT, and in comparison with immediate ADT. |
format | Online Article Text |
id | pubmed-7016808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-70168082020-02-28 A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer De Bleser, Elise Willems, Ruben Decaestecker, Karel Annemans, Lieven De Bruycker, Aurélie Fonteyne, Valérie Lumen, Nicolaas Ameye, Filip Billiet, Ignace Joniau, Steven De Meerleer, Gert Ost, Piet Bultijnck, Renée Cancers (Basel) Article The optimal management of patients with oligorecurrent prostate cancer (PCa) is unknown. There is growing interest in metastasis-directed therapy (MDT) for this population. The objective was to assess cost-utility from a Belgian healthcare payer’s perspective of MDT and delayed androgen deprivation therapy (ADT) in comparison with surveillance and delayed ADT, and with immediate ADT. A Markov decision-analytic trial-based model was developed, projecting the results over a 5-year time horizon with one-month cycles. Clinical data were derived from the STOMP trial and literature. Treatment costs were derived from official government documents. Probabilistic sensitivity analyses showed that MDT is cost-effective compared to surveillance (ICER: €8393/quality adjusted life year (QALY)) and immediate ADT (dominant strategy). The ICER is most sensitive to utilities in the different health states and the first month MDT cost. At a willingness-to-pay threshold of €40,000 per QALY, the cost of the first month MDT should not exceed €8136 to be cost-effective compared to surveillance. The Markov-model suggests that MDT for oligorecurrent PCa is potentially cost-effective in comparison with surveillance and delayed ADT, and in comparison with immediate ADT. MDPI 2020-01-04 /pmc/articles/PMC7016808/ /pubmed/31947974 http://dx.doi.org/10.3390/cancers12010132 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article De Bleser, Elise Willems, Ruben Decaestecker, Karel Annemans, Lieven De Bruycker, Aurélie Fonteyne, Valérie Lumen, Nicolaas Ameye, Filip Billiet, Ignace Joniau, Steven De Meerleer, Gert Ost, Piet Bultijnck, Renée A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title | A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title_full | A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title_fullStr | A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title_full_unstemmed | A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title_short | A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer |
title_sort | trial-based cost-utility analysis of metastasis-directed therapy for oligorecurrent prostate cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016808/ https://www.ncbi.nlm.nih.gov/pubmed/31947974 http://dx.doi.org/10.3390/cancers12010132 |
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