Costs of early adjuvant radiation therapy after radical prostatectomy: A decision analysis Full Text
Annals of Oncology, 07/06/2011  Clinical Article

Showalter TN et al. – ART appears cost effective compared with observation based upon this decision analysis model. Future research should consider more costly radiation therapy (RT) approaches, such as intensity-modulated RT, and should evaluate the cost-effectiveness of ART versus early salvage RT.

• Decision analysis model designed to compare ART versus observation over 10-year time horizon
• Probabilities of treatment success, utilization of salvage treatments, and rates of adverse events were taken from published results of SWOG 8794
• Cost inputs were based on 2010 Medicare reimbursement rates
• Primary outcome measure was incremental cost per prostate-specific antigen (PSA) success (i.e. serum PSA level <0.4 ng/ml)

• ART results in a higher PSA success rate than observation with probability of 0.43 versus 0.22
• Mean incremental cost per patient for ART versus observation was $6023
• Mean incremental cost-effectiveness ratio $26,983 over 10-year period