Next Article in Journal
Preclinical Models of Craniospinal Irradiation for Medulloblastoma
Previous Article in Journal
The Role of Transient Receptor Potential Melastatin 7 (TRPM7) in Cell Viability: A Potential Target to Suppress Breast Cancer Cell Cycle
Previous Article in Special Issue
Influence of Radiotherapy Fractionation Schedule on the Tumor Vascular Microenvironment in Prostate and Lung Cancer Models
Open AccessArticle

A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer

1
Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium
2
Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
3
Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
4
Department of Radiotherapy and Experimental Cancer Research, Ghent University Hospital, 9000 Ghent, Belgium
5
Department of Urology, AZ Maria Middelares, 9000 Ghent, Belgium
6
Department of Urology, AZ Groeninge, 8500 Kortrijk, Belgium
7
Department of Urology, UZ Leuven, 3000 Leuven, Belgium
8
Department of Radiotherapy, UZ Leuven, 3000 Leuven, Belgium
9
Faculty of Medicine, University of Ghent, 9000 Ghent, Belgium
10
Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(1), 132; https://doi.org/10.3390/cancers12010132
Received: 28 October 2019 / Revised: 18 December 2019 / Accepted: 2 January 2020 / Published: 4 January 2020
(This article belongs to the Special Issue Prostate Cancer Radiotherapy)
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. View Full-Text
Keywords: cost-utility analysis; metastasis-directed therapy; oligorecurrent; prostate cancer; oligometastasis; prostatic neoplasms; cost-effective; markov model cost-utility analysis; metastasis-directed therapy; oligorecurrent; prostate cancer; oligometastasis; prostatic neoplasms; cost-effective; markov model
Show Figures

Figure 1

MDPI and ACS Style

De Bleser, E.; Willems, R.; Decaestecker, K.; Annemans, L.; De Bruycker, A.; Fonteyne, V.; Lumen, N.; Ameye, F.; Billiet, I.; Joniau, S.; De Meerleer, G.; Ost, P.; Bultijnck, R. A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer. Cancers 2020, 12, 132.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop