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| Home > Articles > Published articles > Economic Evaluation of Traditional Treatments for Localized Prostate Cancer : |
(Institut Hospital del Mar d'Investigacions Mèdiques) (Institut Hospital del Mar d'Investigacions Mèdiques) (Institut Hospital del Mar d'Investigacions Mèdiques) (Institut Hospital del Mar d'Investigacions Mèdiques) (Institut Català d'Oncologia) (Hospital Universitari de Bellvitge) (Institutu Onkologikoa) (Hospital Universitari i Politècnic La Fe (València)) (Centro Oncológico de Galicia) (Hospital Universitario Ramón y Cajal (Madrid)) (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia)) (Institut de Recerca Sant Pau) (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya)) (Universitat Pompeu Fabra) (Institut Hospital del Mar d'Investigacions Mèdiques) (Institut Català d'Oncologia) (Hospital Universitari de Bellvitge)| Date: | 2025 |
| Abstract: | Objectives: To perform a cost-effectiveness analysis based on primary data from a cohort of patients with localized prostate cancer followed throughout 10 years, comparing radical prostatectomy, brachytherapy, and external beam radiotherapy (EBRT) and applying disease-specific utilities, from a national health system's perspective. Materials and Methods: Patients diagnosed with localized prostate cancer were consecutively recruited in 2003-2005 from 10 Spanish hospitals (n = 674) (ClinicalTrials. gov number: NCT01492751). The expanded prostate cancer index composite (EPIC) and short-form 36 (SF-36) questionnaires were administered through telephone interviews before treatment and annually during follow-up. The outcome measures to evaluate the incremental cost-effectiveness ratio between treatments (ICER) were quality-adjusted life-years (QALYs), calculated by the patient-oriented prostate utility scale (PORPUS) utility index, obtained with a mapping from the EPIC and the SF-36, and survival data. Ten-year medical activities were used to derive costs. Both unweighted and propensity score-weighted analyses were performed. Results: The weighted mean of 10-year QALYs was the highest for radical prostatectomy (8. 53), followed by brachytherapy (8. 49) and external radiotherapy (8. 20), but the difference was only statistically significant with the latter. Costs were significantly higher for brachytherapy (€21,348) than radical prostatectomy (€12,281) and EBRT (€7,560). Compared to EBRT, the weighted ICER for radical prostatectomy was €14,169/QALY gained and €48,417/QALY for brachytherapy. Conclusion: Our findings support that radical prostatectomy was the most cost-effective alternative, but the differences in effectiveness among the three treatments were small. The incremental cost of radical prostatectomy and brachytherapy compared to EBRT, however, does not justify restricting these alternatives. Trial Registration: ClinicalTrials. gov identifier: NCT01492751. |
| Grants: | Instituto de Salud Carlos III PI21/00023 Ministerio de Ciencia e Innovación PI08/90090 Ministerio de Economía y Competitividad PI13/00412 Agència de Gestió d'Ajuts Universitaris i de Recerca 2021/SGR-00624 |
| Rights: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Language: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Subject: | Cost-utility analysis ; Economic evaluation ; External radiotherapy ; Localized prostate cancer ; Preplanned brachytherapy ; QALYs ; Quality-adjusted life years ; Radical prostatectomy |
| Published in: | European Journal of Cancer Care, Vol. 2025 Núm. 1 (2025) , p. 3563061, ISSN 1365-2354 |
