Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia

Rachel Song; Varinder Jeet; Rajan Sharma; Martin Hoyle; Bonny Parkinson

doi:10.1007/s40273-022-01156-4

Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia

Rachel Song, Varinder Jeet, Rajan Sharma, Martin Hoyle, Bonny Parkinson^*

^*Corresponding author for this work

Australian Institute of Health Innovation

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

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Abstract

Background and Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer.

Perspective: Australian healthcare perspective.

Setting: Tertiary.

Methods: A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$).

Results: The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained.

Conclusions: PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

Original language	English
Pages (from-to)	807-821
Number of pages	15
Journal	PharmacoEconomics
Volume	40
Issue number	8
Early online date	27 Jun 2022
DOIs	https://doi.org/10.1007/s40273-022-01156-4
Publication status	Published - Aug 2022

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Publisher version (open access)Final published version, 1.15 MBLicence: CC BY-NC

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@article{966c35a5c1d247ea9974674fa437765e,

title = "Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia",

abstract = "Background and Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. Perspective: Australian healthcare perspective. Setting: Tertiary. Methods: A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A\$). Results: The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A \$21,147/quality-adjusted life-year gained versus CT+WBBS, and A\$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91\% versus CT+WBBS and 89\% versus CT alone, using a threshold of AU\$50,000/quality-adjusted life-year gained. Conclusions: PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.",

author = "Rachel Song and Varinder Jeet and Rajan Sharma and Martin Hoyle and Bonny Parkinson",

note = "{\textcopyright} The Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2022",

month = aug,

doi = "10.1007/s40273-022-01156-4",

language = "English",

volume = "40",

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T1 - Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia

AU - Song, Rachel

AU - Jeet, Varinder

AU - Sharma, Rajan

AU - Hoyle, Martin

AU - Parkinson, Bonny

N1 - © The Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2022/8

Y1 - 2022/8

N2 - Background and Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. Perspective: Australian healthcare perspective. Setting: Tertiary. Methods: A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). Results: The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. Conclusions: PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

AB - Background and Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. Perspective: Australian healthcare perspective. Setting: Tertiary. Methods: A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). Results: The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. Conclusions: PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

UR - https://www.scopus.com/pages/publications/85132846757

U2 - 10.1007/s40273-022-01156-4

DO - 10.1007/s40273-022-01156-4

M3 - Article

C2 - 35761117

SN - 1170-7690

VL - 40

SP - 807

EP - 821

JO - PharmacoEconomics

JF - PharmacoEconomics

IS - 8

ER -

Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia

Abstract

Bibliographical note

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Australian hitech manufacturer takes-on prostate cancer

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Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia

Abstract

Bibliographical note

Access to Document

Other files and links

Fingerprint

Projects

Australian hitech manufacturer takes-on prostate cancer

Cite this