The Value of a New Diagnostic Test for Prostate Cancer : A Cost-Utility Analysis in Early Stage of Development
Fridhammar, Adam ; Axelsson, Ulrika LU
; Persson, Ulf
; Bjartell, Anders
LU
and Borrebaeck, Carl A.K.
LU
(2021)
In PharmacoEconomics - Open
5(1).
p.77-88
- Abstract
Background: Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective: The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method: We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer... (More)
Background: Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective: The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method: We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer diagnosis, treatments and prostate cancer deaths. The analysis was performed from a health care perspective. It used epidemiologic data, treatment patterns, and health care costs from the Swedish region Skåne (population of 1.3 million). A 90% sensitivity and specificity of the new test was assumed. Results: Among 31,250 men, age 50–69 years, 16.4% had a PSA between 3.0 and 9.9 µg/L and 28.9% a PSA of 2.0–9.9 µg/L. Testing men with PSA 3.0–9.9 µg/L, as in current clinical practice, decreased the number of biopsies by 3595, detected 61 more cancers, resulting in and two more fatalities and subsequently a loss of 14 QALYs. Cost offsets could justify a test value of SEK 4996. Testing a larger population, PSA 2.0–9.9 µg/L prevented 6 deaths, added 50 QALYs, and could justify a value of the test of SEK 5165, given a value of health of SEK 500,000 per QALY. Conclusion: A new blood-based test for prostate cancer has a significant potential to reduce the number of biopsies needed, resulting in reduced health care costs and improve patient care.
(Less)
- author
- Fridhammar, Adam
; Axelsson, Ulrika
LU
; Persson, Ulf
; Bjartell, Anders
LU
and Borrebaeck, Carl A.K.
LU
- organization
- publishing date
- 2021-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- PharmacoEconomics - Open
- volume
- 5
- issue
- 1
- pages
- 12 pages
- publisher
- Springer
- external identifiers
-
- pmid:32780268
- scopus:85102356942
- ISSN
- 2509-4262
- DOI
- 10.1007/s41669-020-00226-7
- language
- English
- LU publication?
- yes
- id
- b77d8954-ef02-4215-8e38-8cd893533983
- date added to LUP
- 2021-12-17 13:59:20
- date last changed
- 2024-06-15 22:54:29
@article{b77d8954-ef02-4215-8e38-8cd893533983,
abstract = {{<p>Background: Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective: The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method: We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer diagnosis, treatments and prostate cancer deaths. The analysis was performed from a health care perspective. It used epidemiologic data, treatment patterns, and health care costs from the Swedish region Skåne (population of 1.3 million). A 90% sensitivity and specificity of the new test was assumed. Results: Among 31,250 men, age 50–69 years, 16.4% had a PSA between 3.0 and 9.9 µg/L and 28.9% a PSA of 2.0–9.9 µg/L. Testing men with PSA 3.0–9.9 µg/L, as in current clinical practice, decreased the number of biopsies by 3595, detected 61 more cancers, resulting in and two more fatalities and subsequently a loss of 14 QALYs. Cost offsets could justify a test value of SEK 4996. Testing a larger population, PSA 2.0–9.9 µg/L prevented 6 deaths, added 50 QALYs, and could justify a value of the test of SEK 5165, given a value of health of SEK 500,000 per QALY. Conclusion: A new blood-based test for prostate cancer has a significant potential to reduce the number of biopsies needed, resulting in reduced health care costs and improve patient care.</p>}},
author = {{Fridhammar, Adam and Axelsson, Ulrika and Persson, Ulf and Bjartell, Anders and Borrebaeck, Carl A.K.}},
issn = {{2509-4262}},
language = {{eng}},
number = {{1}},
pages = {{77--88}},
publisher = {{Springer}},
series = {{PharmacoEconomics - Open}},
title = {{The Value of a New Diagnostic Test for Prostate Cancer : A Cost-Utility Analysis in Early Stage of Development}},
url = {{http://dx.doi.org/10.1007/s41669-020-00226-7}},
doi = {{10.1007/s41669-020-00226-7}},
volume = {{5}},
year = {{2021}},
}