Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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
_version_ 1783497060506402816
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
work_keys_str_mv AT debleserelise atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT willemsruben atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT decaesteckerkarel atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT annemanslieven atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT debruyckeraurelie atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT fonteynevalerie atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT lumennicolaas atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT ameyefilip atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT billietignace atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT joniausteven atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT demeerleergert atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT ostpiet atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT bultijnckrenee atrialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT debleserelise trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT willemsruben trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT decaesteckerkarel trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT annemanslieven trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT debruyckeraurelie trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT fonteynevalerie trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT lumennicolaas trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT ameyefilip trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT billietignace trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT joniausteven trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT demeerleergert trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT ostpiet trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer
AT bultijnckrenee trialbasedcostutilityanalysisofmetastasisdirectedtherapyforoligorecurrentprostatecancer