Cost analysis of prostate cancer detection including the prostate health index (phi)

Cost analysis of prostate cancer detection including the prostate health index (phi) Objective To assess the economic impact of introducing the prostate health index (phi) for prostate cancer (PCa) detection. Methods A total of 177 patients who presented in an academic institution with a tPSA between 2 and 10 ng/ml and under- went prostate biopsies within the 3 months were enrolled. With phi and tPSA thresholds of 43 and 4 ng/ml, respectively, probability for each branch of a decision tree model for PCa diagnosis and corresponding mean cost were estimated with “Monte Carlo” simulations. A sensitivity analysis was performed. Results With a similar sensitivity, phi strategy increased positive predictive value by 13.9 points and negative predictive value by 31.6 points in comparison to tPSA strategy. Mean costs per patient with tPSA and phi strategies were €514 and €528, respectively, for a phi test price at 50€. One-way sensitivity analysis showed that phi strategy was less expensive (508€/patient) than tPSA strategy with a phi test price below 30€. In multi-criteria sensitivity analysis, PPV and the rates of positive phi and tPSA were the parameters with the largest impact on the final cost as opposed to the cost of the biopsy or imaging which have less influence. With an expected rate of positive phi test < http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Urology Springer Journals

Cost analysis of prostate cancer detection including the prostate health index (phi)

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Urology; Nephrology; Oncology
ISSN
0724-4983
eISSN
1433-8726
D.O.I.
10.1007/s00345-018-2362-z
Publisher site
See Article on Publisher Site

Abstract

Objective To assess the economic impact of introducing the prostate health index (phi) for prostate cancer (PCa) detection. Methods A total of 177 patients who presented in an academic institution with a tPSA between 2 and 10 ng/ml and under- went prostate biopsies within the 3 months were enrolled. With phi and tPSA thresholds of 43 and 4 ng/ml, respectively, probability for each branch of a decision tree model for PCa diagnosis and corresponding mean cost were estimated with “Monte Carlo” simulations. A sensitivity analysis was performed. Results With a similar sensitivity, phi strategy increased positive predictive value by 13.9 points and negative predictive value by 31.6 points in comparison to tPSA strategy. Mean costs per patient with tPSA and phi strategies were €514 and €528, respectively, for a phi test price at 50€. One-way sensitivity analysis showed that phi strategy was less expensive (508€/patient) than tPSA strategy with a phi test price below 30€. In multi-criteria sensitivity analysis, PPV and the rates of positive phi and tPSA were the parameters with the largest impact on the final cost as opposed to the cost of the biopsy or imaging which have less influence. With an expected rate of positive phi test <

Journal

World Journal of UrologySpringer Journals

Published: Jul 6, 2018

References

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