Prostate cancer: costs of surveillance, surgery and radiotherapy in the NHS

  • Noble SM & al.
  • Br J Cancer
  • 16 Jul 2020

  • curated by Dawn O'Shea
  • UK Medical News
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The latest results from the Prostate Testing for Cancer and Treatment (ProtecT) randomised controlled trial suggest radiotherapy is the most cost-effective treatment for localised prostate cancer.

The study compared the cost-effectiveness of active monitoring, surgery and radiotherapy from a UK NHS perspective at 10 years’ median follow-up.

The findings, reported in the British Journal of Cancer, show adjusted mean quality-adjusted life-years (QALYs) of 6.89 with active monitoring, 7.09 with radiotherapy and 6.91 with surgery.

Active monitoring had lower adjusted mean costs (£5913) than radiotherapy (£7361) and surgery (£7519).

Radiotherapy was the most likely (58% probability) cost-effective option at the UK National Institute for Clinical Excellence (NICE) willingness-to-pay threshold of £20,000 per QALY.

Subgroup analyses confirmed radiotherapy was cost-effective for older men and intermediate/high-risk disease groups. Active monitoring was more likely to be the cost-effective option for younger men and low-risk groups.

Over the median 10-year period, the mean cost-difference between the radiotherapy and surgery groups was only £159.

This study is the first and only economic evaluation within a randomised trial comparing the three contemporary major treatment modalities.

The authors say longer follow-up and modelling are required to determine the most cost-effective treatment for localised prostate cancer over a man’s lifetime.