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Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven
Nikhil G Thaker1, Thomas J Pugh2, Usama Mahmood2
1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX.
Brachytherapy
|February 27, 2016
Summary
Prostate brachytherapy (PBT) offers excellent outcomes for low-risk prostate cancer with low costs. This study developed a value framework using standardized outcomes and time-driven activity-based costing (TDABC) for PBT treatments.
Area of Science:
- Oncology
- Health Economics
- Medical Technology Assessment
Background:
- Value-based healthcare models are increasingly important for evaluating medical treatments.
- Prostate cancer (PCa) treatment evaluation requires robust outcome and cost data.
- Standardized outcome measures and cost analysis are crucial for defining treatment value.
Purpose of the Study:
- To establish a value framework for prostate brachytherapy (PBT) using standardized outcomes and time-driven activity-based costing (TDABC).
- To analyze the cost-effectiveness and patient outcomes of PBT for low-risk prostate cancer.
Main Methods:
- Analysis of standardized outcomes (toxicity, patient-reported outcomes, survival) for 238 men with low-risk PCa treated with PBT (1998-2009).
- Application of TDABC to collect patient-level costs up to 1 year post-treatment.
- Utilized process mapping and radar charts for value visualization.
Main Results:
- PBT demonstrated favorable 10-year outcomes: 84.1% biochemical failure-free survival, 99.6% metastasis-free survival, 100% PCa-specific survival, and 88.6% overall survival.
- No acute Grade 3-5 complications were observed; patient-reported outcomes remained favorable.
- TDABC revealed low resource utilization, with 41% of costs in the OR and 10% for MRI scans.
Conclusions:
- A visual value framework for PBT was successfully created using standardized outcomes and TDABC.
- PBT is associated with excellent patient outcomes and low treatment costs.
- This methodology facilitates value comparisons across different providers and treatment options.
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