A decision-analytic cost-effectiveness model to compare treatment options for radiation recurrent prostate cancer against androgen deprivation therapy

Boyd, K.A. , Jones, R.J. , Paul, J. , Briggs, A. and Leung, H.Y. (2014) A decision-analytic cost-effectiveness model to compare treatment options for radiation recurrent prostate cancer against androgen deprivation therapy. British Journal of Surgery, 101(s4), p. 59. (doi:10.1002/bjs.9510)

Full text not currently available from Enlighten.

Publisher's URL: http://dx.doi.org/10.1002/bjs.9510

Abstract

Objective: To determine the cost-effectiveness of Cryotherapy in men with radio-recurrent prostate cancer (RRPC), from the perspective of the UK National Health Service.<p></p> Design: A cost-utility analysis was undertaken using decision analytic modelling. A Markov model was developed for men with RRPC to assess the cost-effectiveness of Cryotherapy compared to androgen deprivation therapy (ADT) which is current practice in this patient group. A literature review was undertaken and data from published sources was used to inform the decision model; the Scottish Prostate Cryotherapy Service informed resource use and Department of Health reference costs were used for cost year 2011. Outcome Measurements and Statistical Analysis: Results are reported as the discounted incremental costs and quality adjusted life years (QALYs) gained between the two alternative interventions. Probabilistic sensitivity analysis used a 10,000 iteration Monte Carlo simulation.<p></p> Results: Cryotherapy has a high upfront treatment cost, but delays the ongoing monthly cost of ADT until progression has occurred. Relative to ADT, Cryotherapy is the dominant strategy over the patient lifetime, with an incremental gain of 1.16 QALYs (95% CI 0.70, 1.66) and a reduced lifetime cost of £38,924 (95% CI -£71,377, -£16,878). There was a lack of robust evidence on progression free survival and no evidence which directly compared the two interventions. Uncertainty was accounted for in probabilistic and scenario sensitivity analyses, however the model results are not sensitive to parameter or structural uncertainty. Conclusions: Cryotherapy is a dominant strategy in comparison to ADT, costing less over a patient’s lifetime with improvements in QALYs.<p></p>

Item Type:Articles
Additional Information:Abstract for paper presented at the Society of Academic and Research Surgery (SARS) Annual Meeting, Cambridge, UK, 8–9 January 2014
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Paul, Mr James and Leung, Professor Hing and Briggs, Professor Andrew and Jones, Professor Robert and Boyd, Dr Kathleen
Authors: Boyd, K.A., Jones, R.J., Paul, J., Briggs, A., and Leung, H.Y.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:British Journal of Surgery
Publisher:Wiley-Blackwell
ISSN:0007-1323
ISSN (Online):1365-2168

University Staff: Request a correction | Enlighten Editors: Update this record