前列腺癌风险评估方法的经济评估:使用人口数据进行成本效益分析
Tima Mohammadi1, Daphne P Guh1, Alexander C T Tam1
1Centre for Advancing Health Outcomes (formerly Centre for Health Evaluation and Outcome Sciences), Providence Health Care Research Institute, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Cancer medicine
|September 23, 2023
概括
新的前列腺癌风险评估工具 (RAT) 可以具有成本效益,改善边缘PSA水平的男性的活检决策. 与标准护理相比,这些工具提供了潜在的成本节约和改善的健康结果.
科学领域:
- 卫生经济学 卫生经济学
- 在瘤学瘤学.
- 生物标志物研究 生物标志物研究
背景情况:
- 目前的前列腺癌 (PCa) 查依赖于前列腺特异性抗原 (PSA) 水平,导致由于3-10 ng/mL范围内的低特异性导致过度治疗.
- 新的风险评估工具 (RAT) 正在开发中,以提高PCa查中的活检决策准确性.
- 这项研究评估了不列颠哥伦比亚省医疗保健系统中新型RAT的成本效益.
研究的目的:
- 评估一种新的风险评估工具 (RAT) 的成本效益,用于指导中等PSA水平的男性前列腺癌 (PCa) 活检.
- 从医疗保健系统的角度开发一个建模框架来评估新的RAT.
- 为了比较RAT的成本效益与PCa查的护理标准 (SOC).
主要方法:
- 使用一个依赖时间的状态过渡模型来评估RAT在50岁以上未经活检的男性中具有PSA水平在3-10 ng/mL之间的成本效益.
- 该模型由患者合作伙伴,链接的行政健康数据和发表的文献提供了信息.
- 使用概率分析计算增量成本效益比率 (ICER) 并评估参数不确定性.
主要成果:
- RAT是一个占主导地位的策略,在18年内节省了44美元的成本,并获得了0.00253个质量调整寿命年 (QALY).
- 在5万美元/QALY门下,RAT与SOC相比,具有73%的成本效益概率.
- 结果对RAT准确度 (特别是高等级PCa检测),成本和PCa流行程度敏感.
结论:
- 实施准确的RAT以指导前列腺癌活检是一个具有成本效益的策略.
- 开发的建模框架为评估各种新型RAT的成本效益提供了可概括的方法.
- 改进的风险分层可以优化活检决策,可能减少不必要的程序和过度治疗.
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