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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

Author

Listed:
  • Rachel Song

    (Macquarie University
    Macquarie University)

  • Varinder Jeet

    (Macquarie University
    Macquarie University)

  • Rajan Sharma

    (Macquarie University
    Macquarie University)

  • Martin Hoyle

    (Macquarie University
    Macquarie University)

  • Bonny Parkinson

    (Macquarie University
    Macquarie University)

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.

Suggested Citation

  • Rachel Song & Varinder Jeet & Rajan Sharma & Martin Hoyle & Bonny Parkinson, 2022. "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," PharmacoEconomics, Springer, vol. 40(8), pages 807-821, August.
    • Handle: RePEc:spr:pharme:v:40:y:2022:i:8:d:10.1007_s40273-022-01156-4
    DOI: 10.1007/s40273-022-01156-4
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    References listed on IDEAS

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    1. Christian E. H. Boehler & Joanne Lord, 2016. "Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries," Medical Decision Making, , vol. 36(1), pages 31-47, January.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
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