The cost, survival, and quality‐of‐life implications of <scp>guideline‐discordant</scp> imaging for prostate cancer

Winn, Aaron N.; Kelly, Matthew; Ciprut, Shannon; Walter, Dawn; Gold, Heather T.; Zeliadt, Steven B.; Sherman, Scott E.; Makarov, Danil V.

doi:10.1002/cnr2.1468

Cited by 5 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In trauma patients, a 37‒47% cost reduction was shown, while the changes in cost were small in the overall use of imaging, as some examinations increased in use while others were reduced. Other studies on various patient groups showed 34‒70% cost reduction [ 59 , 94 , 127 , 128 ].…”

Section: Resultsmentioning

confidence: 99%

Cost of Low-Value Imaging Worldwide: A Systematic Review

Kjelle,

Brandsæter,

Andersen

et al. 2024

Appl Health Econ Health Policy

View full text Add to dashboard Cite

Background and Objective Imaging with low or no benefit for the patient undermines the quality of care and amounts to vast opportunity costs. More than 3.6 billion imaging examinations are performed annually, and about 20–50% of these are of low value. This study aimed to synthesize knowledge of the costs of low-value imaging worldwide. Methods This systematic review was based on the PRISMA statement. The database search was developed in Medline and further adapted to Embase-Ovid, Cochrane Library, and Scopus. Primary empirical studies assessing the costs of low-value diagnostic imaging were included if published between 2012 and March 2022. Studies designed as randomized controlled trials, non-randomized trials, cohort studies, cross-sectional studies, descriptive studies, cost analysis, cost-effectiveness analysis, and mixed-methods studies were eligible. The analysis was descriptive. Results Of 5,567 records identified, 106 were included. Most of the studies included were conducted in the USA ( n = 76), and a hospital or medical center was the most common setting ( n = 82). Thirty-eight of the included studies calculated the costs of multiple imaging modalities; in studies with only one imaging modality included, conventional radiography was the most common ( n = 32). Aggregated costs for low-value examinations amounts to billions of dollars per year globally. Initiatives to reduce low-value imaging may reduce costs by up to 95% without harming patients. Conclusions This study is the first systematic review of the cost of low-value imaging worldwide, documenting a high potential for cost reduction. Given the universal challenges with resource allocation, the large amount used for low-value imaging represents a vast opportunity cost and offers great potential to improve the quality and efficiency of care. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-024-00876-2.

show abstract

Section: Resultsmentioning

confidence: 99%

Cost of Low-Value Imaging Worldwide: A Systematic Review

Kjelle,

Brandsæter,

Andersen

et al. 2024

Appl Health Econ Health Policy

View full text Add to dashboard Cite

show abstract

“…On the contrary, Schultz et al took into account the overall consumption of health services by the patients and reported lower enzalutamide costs due to less use of health services (outpatient, inpatient, and emergency) [ 38 , 39 ]. The important point is that most of these results were obtained by indirect comparisons of the mentioned drugs [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness and budget impact analysis of enzalutamide in comparison to abiraterone in treatment of metastatic prostate cancer resistant to castration in Iran

Goudarzi,

Lotfi,

Najafpour

et al. 2024

BMC Urol

View full text Add to dashboard Cite

Introduction In recent years, enzalutamide and abiraterone have been widely used as treatments for metastatic castration-resistant prostate cancer (mCRPC). However, the cost-effectiveness of these drugs in Iran is unknown. This study evaluated the cost-effectiveness of enzalutamide for the treatment of metastatic prostate cancer resistant to castration in Iran. Methods A 3-state Markov model was developed to evaluate the cost-effectiveness of enzalutamide and abiraterone from a social perspective over 10 years. The clinical inputs were obtained from the meta-analysis studies. The direct medical costs were obtained from the tariffs of the healthcare system, while the direct non-medical and indirect costs were collected from the patients. The data of utilities were derived from the literature. In addition, sensitivity analyses were conducted to assess the uncertainties. Results Compared with Abiraterone, enzalutamide was associated with a high incremental cost-effectiveness ratio (ICER) of $6,260 per QALY gained. According to the one-way sensitivity analysis, ICER was most heavily influenced by the prices of enzalutamide and Abiraterone, non-medical costs, and indirect costs. Regardless of the variation, enzalutamide remained cost-effective. The budget impact analysis of enzalutamide in the health system during 5 years was estimated at $6,362,127. Conclusions At current prices, adding enzalutamide to pharmaceutical lists represents the cost-effective use of the healthcare resources in Iran for the treatment of metastatic castration-resistant prostate cancer.

show abstract

“…Complementarily, the work reflected in the article by Winn et al [ 23 ] created a simulation model to compare “appropriate imaging” with the status quo. According to the authors, applied imaging, radiation, and surgery had an associated cost of US$409, US$23,145 and US$28,507, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, Winn et al [ 23 ] created a state-transition microsimulation model to understand changing population-level patterns of imaging among men with incidental prostate cancer. The results indicated that when only high-risk men were prioritized for imaging tests compared with the status quo (real-world practice from the SEER-Medicare database), both the population rate of imaging tests and average per-person expenditure on imaging tests declined.…”

Section: Discussionmentioning

confidence: 99%

The Economic Burden of Localized Prostate Cancer and Insights Derived from Cost-Effectiveness Studies of the Different Treatments

Cantarero

Lera

Lanza-León

et al. 2022

Cancers

View full text Add to dashboard Cite

Prostate cancer has huge health and societal impacts, and there is no clear consensus on the most effective and efficient treatment strategy for this disease, particularly for localized prostate cancer. We have reviewed the scientific literature describing the economic burden and cost-effectiveness of different treatment strategies for localized prostate cancer in OECD countries. We initially identified 315 articles, studying 13 of them in depth (those that met the inclusion criteria), comparing the social perspectives of cost, time period, geographical area, and severity. The economic burden arising from prostate cancer due to losses in productivity and increased caregiver load is noticeable, but clinical decision-making is carried out with more subjective variability than would be advisable. The direct cost of the intervention was the main driver for the treatment of less severe cases of prostate cancer, whereas for more severe cases, the most important determinant was the loss in productivity. Newer, more affordable radiotherapy strategies may play a crucial role in the future treatment of early prostate cancer. The interpretation of our results depends on conducting thorough sensitivity analyses. This approach may help better understand parameter uncertainty and the methodological choices discussed in health economics studies. Future results of ongoing clinical trials that are considering genetic characteristics in assessing treatment response of patients with localized prostate cancer may shed new light on important clinical and pharmacoeconomic decisions.

show abstract

The cost, survival, and quality‐of‐life implications of guideline‐discordant imaging for prostate cancer

Cited by 5 publications

References 25 publications

Cost of Low-Value Imaging Worldwide: A Systematic Review

Cost of Low-Value Imaging Worldwide: A Systematic Review

Cost-effectiveness and budget impact analysis of enzalutamide in comparison to abiraterone in treatment of metastatic prostate cancer resistant to castration in Iran

The Economic Burden of Localized Prostate Cancer and Insights Derived from Cost-Effectiveness Studies of the Different Treatments

Contact Info

Product

Resources

About