Cost-effectiveness analysis of PSA-based mass screening: Evidence from a randomised controlled trial combined with register data
Autoři:
Neill Booth aff001; Pekka Rissanen aff001; Teuvo L. J. Tammela aff002; Paula Kujala aff003; Ulf-Håkan Stenman aff005; Kimmo Taari aff006; Kirsi Talala aff007; Anssi Auvinen aff001
Působiště autorů:
Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
aff001; Department of Urology, Tampere University Hospital, Tampere, Finland
aff002; Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
aff003; Department of Pathology, Fimlab Laboratories, Tampere, Finland
aff004; Department of Clinical Chemistry and Haematology, University of Helsinki, Helsinki, Finland
aff005; Department of Urology, University of Helsinki, Helsinki, Finland
aff006; Finnish Cancer Registry, Helsinki, Finland
aff007
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0224479
Souhrn
In contrast to earlier studies which have used modelling to perform cost-effectiveness analysis, this study links data from a randomised controlled trial with register data from nationwide registries to reveal new evidence on costs, effectiveness, and cost-effectiveness of organised mass prostate-cancer screening based on prostate-specific antigen (PSA) testing. Cost-effectiveness analyses were conducted with individual-level data on health-care costs from comprehensive registers and register data on real-world effectiveness from the two arms of the Finnish Randomised Study of Screening for Prostate Cancer (FinRSPC), following 80,149 men from 1996 through 2015. The study examines cost-effectiveness in terms of overall mortality and, in addition, in terms of diagnosed men’s mortality from prostate cancer and mortality with but not from prostate cancer. Neither arm of the FinRSPC was clearly more cost-effective in analysis in terms of overall mortality. Organised screening in the FinRSPC could be considered cost-effective in terms of deaths from prostate cancer: averting just over one death per 1000 men screened. However, even with an estimated incremental cost-effectiveness ratio of below 20,000€ per death avoided, this result should not be considered in isolation. This is because mass screening in this trial also resulted in increases in death with, but not from, prostate cancer: with over five additional deaths per 1000 men screened. Analysis of real-world data from the FinRSPC reveals new evidence of the comparative effectiveness of PSA-based screening after 20 years of follow-up, suggesting the possibility of higher mortality, as well as higher healthcare costs, for screening-arm men who have been diagnosed with prostate cancer but who do not die from it. These findings should be corroborated or contradicted by similar analyses using data from other trials, in order to reveal if more diagnosed men have also died in the screening arms of other trials of mass screening for prostate cancer.
Klíčová slova:
Cancer detection and diagnosis – Cancer screening – Cost-effectiveness analysis – Death rates – Health economics – Prostate cancer – Randomized controlled trials – Finnish people
Zdroje
1. Schröder FH, Hugosson J, Roobol MJ, Tammela TLJ, Ciatto S, Nelen V, et al. Prostate-Cancer Mortality at 11 Years of Follow-up. New England Journal of Medicine. 2012;366(11):981–90. doi: 10.1056/NEJMoa1113135 22417251
2. Schröder FH, Hugosson J, Roobol MJ, Tammela TLJ, Zappa M, Nelen V, et al. Screening and prostate cancer mortality: Results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384(9959):2027–35. doi: 10.1016/S0140-6736(14)60525-0 25108889
3. Kilpeläinen TP, Tammela TL, Malila N, Hakama M, Santti H, Määttänen L, et al. Prostate cancer mortality in the Finnish Randomized Screening Trial. Journal of the National Cancer Institute. 2013;105(10):719–25. doi: 10.1093/jnci/djt038 23479454
4. Pinsky PF, Miller E, Prorok P, Grubb R, Crawford ED, Andriole G. Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. BJU Int. 2019;123(5):854–60. doi: 10.1111/bju.14580 30288918
5. Booth N, Rissanen P, Tammela T, Taari K, Talala K, Auvinen A. Costs of screening for prostate cancer: Evidence from the Finnish Randomised Study of Screening for Prostate Cancer after 20-year follow-up using register data. European Journal of Cancer. 2018;93:108–18. doi: 10.1016/j.ejca.2018.01.111 29501976
6. Krahn M, Zagorski B, Laporte A, Alibhai SMH, Bremner KE, Tomlinson G, et al. Healthcare costs associated with prostate cancer: estimates from a population-based study. BJU International. 2010;105(3):338–46. doi: 10.1111/j.1464-410X.2009.08758.x 19594734
7. Yates DR, Anderson JB. Screening for prostate cancer. In: Tewari A, editor. Prostate Cancer: A Comprehensive Perspective. London: Springer-Verlag; 2013. p. 333–46.
8. Haines IE, Ablin RJ, Miklos GLG. Screening for prostate cancer: time to put all the data on the table. BMJ. 2016;353. doi: 10.1136/bmj.i2574 27226459
9. Weinstein MC, Stason WB. Foundations of cost-effectiveness analysis for health and medical practices. New England Journal of Medicine. 1977;296(13):716–21. doi: 10.1056/NEJM197703312961304 402576
10. Russell LB, Sinha A. Strengthening Cost-Effectiveness Analysis for Public Health Policy. American Journal of Preventive Medicine. 2016;50(5, Supplement 1):S6–S12. doi: 10.1016/j.amepre.2015.11.007 27102861
11. Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S. Applied Methods of Cost-effectiveness Analysis in Health Care. Gray A, Briggs A, editors. Oxford: Oxford University Press; 2011.
12. Neumann PJ, Kim DD, Trikalinos TA, Sculpher MJ, Salomon JA, Prosser LA, et al. Future Directions for Cost-effectiveness Analyses in Health and Medicine. Med Decis Making. 2018;38(7):767–77. doi: 10.1177/0272989X18798833 30248277
13. Glick H, Doshi J, Sonnad S, Polsky D. Economic Evaluation in Clinical Trials. Gray A, Briggs A, editors. Oxford: Oxford University Press; 2014.
14. Noordzij MA, Blanker MH. Re: Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. Journal of the National Cancer Institute. 2015;107(6):djv110. doi: 10.1093/jnci/djv110 25888716
15. Auvinen A. Prostate cancer screening: What can we learn from randomised trials? Translational Andrology and Urology. 2018;7(1):12–7. doi: 10.21037/tau.2017.12.13 29594015
16. Ramsberg J, Neovius M. Register or electronic health records enriched randomized pragmatic trials: The future of clinical effectiveness and cost-effectiveness trials? Nordic Journal of Health Economics. 2017;5(1):62–76. doi: 10.5617/njhe.1386
17. Sackett DL. The arrogance of preventive medicine. CMAJ. 2002;167(4):363–4. 12197692
18. The Nordic Classification Centre. NordDRG Users’ Manual 2012 [19/06/19]. http://www.nordcase.org/eng/materials/manuals/.
19. Ramsey SD, Willke RJ, Glick H, Reed SD, Augustovski F, Jonsson B, et al. Cost-effectiveness analysis alongside clinical trials II–an ISPOR Good Research Practices Task Force report. Value in Health. 2015;18(2):161–72. doi: 10.1016/j.jval.2015.02.001 25773551
20. Booth N, Rissanen P, Tammela TLJ, Määttänen L, Taari K, Auvinen A. Health-related quality of life in the Finnish Trial of Screening for Prostate Cancer. European Urology. 2014;65(1):39–47. doi: 10.1016/j.eururo.2012.11.041 23265387
21. European Network for Health Technology Assessment (EUnetHTA). Methods for health economic evaluations—a guideline based on current practices in Europe. http://www.eunethta.eu/sites/5026.fedimbo.belgium.be/files/2015-04-29-ECO-GL_Final%20version_0.pdf. 2015.
22. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)–explanation and elaboration: A Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value in Health. 2013;16(2):231–50. doi: 10.1016/j.jval.2013.02.002 23538175
23. StataCorp LLC. Stata statistical software: Release 15.1. College Station, TX. 2019.
24. Schulz KF, Altman DG, Moher D, Group C. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152(11):726–32. doi: 10.7326/0003-4819-152-11-201006010-00232 20335313
25. Deaton A, Cartwright N. Understanding and misunderstanding randomized controlled trials. Social Science & Medicine. 2018;210:2–21. doi: 10.1016/j.socscimed.2017.12.005 29331519
26. Basu A, Maciejewski ML. Choosing a Time Horizon in Cost and Cost-effectiveness Analyses. JAMA. 2019;321(11):1096–7. doi: 10.1001/jama.2019.1153 30789668
27. Goodwin P, Wright G. The limits of forecasting methods in anticipating rare events. Technological Forecasting and Social Change. 2010;77(3):355–68. doi: 10.1016/j.techfore.2009.10.008
28. Sobin LH, Wittekind C, Gospodarowicz MK. TNM Classification of Malignant Tumours. Oxford: Wiley-Blackwell; 2010.
29. Tsodikov A, Gulati R, Heijnsdijk EAM, Pinsky PF, Moss SM, Qiu S, et al. Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials. Ann Intern Med. 2017;167(7):449–55. doi: 10.7326/M16-2586 28869989
30. Editorial. DIfferent effects of screening on prostate cancer death in two trials. Annals of Internal Medicine. 2017.
31. Prasad V, Lenzer J, Newman DH. Why cancer screening has never been shown to ‘save lives’–and what we can do about it. BMJ. 2016;352. doi: 10.1136/bmj.h6080 26740343
32. Roth JA, Gulati R, Gore JL, Cooperberg MR, Etzioni R. Economic analysis of prostate-specific antigen screening and selective treatment strategies. JAMA Oncology. 2016;2(7):890–8. doi: 10.1001/jamaoncol.2015.6275 27010943
33. Shteynshlyuger A, Andriole GL. Cost-Effectiveness of Prostate Specific Antigen Screening in the United States: Extrapolating From the European Study of Screening for Prostate Cancer. The Journal of Urology. 2011;185(3):828–32. doi: 10.1016/j.juro.2010.10.079 21239021
34. Pataky R, Gulati R, Etzioni R, Black P, Chi KN, Coldman AJ, et al. Is prostate cancer screening cost-effective? A microsimulation model of prostate-specific antigen-based screening for British Columbia, Canada. International Journal of Cancer. 2014;135(4):939–47. doi: 10.1002/ijc.28732 24443367
35. Shin S, Kim YH, Hwang JS, Lee YJ, Lee SM, Ahn J. Economic evaluation of prostate cancer screening test as a national cancer screening program in South Korea. Asian Pac J Cancer Prev. 2014;15(8):3383–9. doi: 10.7314/apjcp.2014.15.8.3383 24870726
36. Heijnsdijk EAM, de Carvalho TM, Auvinen A, Zappa M, Nelen V, Kwiatkowski M, et al. Cost-effectiveness of prostate cancer screening: A simulation study based on ERSPC data. Journal of the National Cancer Institute. 2015;107(1). doi: 10.1093/jnci/dju366 25505238
37. Mullahy J. Health and evidence in health economics. Health Economics. 2019;28(10):1163–5. doi: 10.1002/hec.3926 31264292
38. Kilpeläinen TP, Pogodin-Hannolainen D, Kemppainen K, Talala K, Raitanen J, Taari K, et al. Estimate of opportunistic prostate specific antigen testing in the Finnish Randomized Study of Screening for Prostate Cancer. The Journal of Urology. 2017;198(1):50–7. doi: 10.1016/j.juro.2017.01.048 28104375
39. Booth N. On value frameworks and opportunity costs in health technology assessment. International Journal of Technology Assessment in Health Care. 2019. doi: 10.1017/S0266462319000643 31530332
40. Sullivan SD, Mauskopf JA, Augustovski F, Jaime Caro J, Lee KM, Minchin M, et al. Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value in Health. 2014;17(1):5–14. doi: 10.1016/j.jval.2013.08.2291 24438712
41. Bertram MY, Lauer JA, De Joncheere K, Edejer T, Hutubessy R, Kieny M-P, et al. Cost-effectiveness thresholds: pros and cons. Bulletin of the World Health Organization. 2016;94(12):925–30. doi: 10.2471/BLT.15.164418 27994285
42. Krauss A. Why all randomised controlled trials produce biased results. Annals of Medicine. 2018;50(4):312–22. doi: 10.1080/07853890.2018.1453233 29616838
43. Manski CF. The lure of incredible certitude. Economics and Philosophy. 2019:1–30. doi: 10.1017/S0266267119000105
44. Krahn MD, Mahoney JE, Eckman MH, Trachtenberg J, Pauker SG, Detsky AS. Screening for prostate cancer: A decision analytic view. JAMA. 1994;272(10):773–80. 7521400
45. Quade ES. Introduction and overview. In: Goldman TA, editor. Cost-effectiveness analysis: new approaches in decision-making. New York: Praeger; 1967. p. 1–16.
46. Laxy M, Wilson ECF, Boothby CE, Griffin SJ. Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data. Value in Health. 2017;20(10):1288–98. doi: 10.1016/j.jval.2017.05.018 29241888
47. Heijnsdijk EAM, Csanádi M, Gini A, ten Haaf K, Bendes R, Anttila A, et al. All-cause mortality versus cancer-specific mortality as outcome in cancer screening trials: A review and modeling study. Cancer Medicine. 2019;8(13):6127–38. doi: 10.1002/cam4.2476 31422585
48. McNaughton-Collins M, Walker-Corkery E, Barry MJ. Health-related quality of life, satisfaction, and economic outcome measures in studies of prostate cancer screening and treatment, 1990–2000. J Natl Cancer Inst Monogr. 2004;(33):78–101. doi: 10.1093/jncimonographs/lgh016 15504921
49. Shoag JE, Mittal S, Hu JC. Reevaluating PSA Testing Rates in the PLCO Trial. New England Journal of Medicine. 2016;374(18):1795–6. doi: 10.1056/NEJMc1515131 27144870
50. Mooney G. Priority setting in mental health services. Applied Health Economics and Health Policy. 2002;1(2):65–74. 14619253
51. Birch S. As a matter of fact: evidence-based decision-making unplugged. Health Economics. 1997;6(6):547–59. 9466138
Článek vyšel v časopise
PLOS One
2019 Číslo 11
- Manuál pro „pertusový rok“: Jak nákazu poznat, léčit... a jak jí předcházet
- Psst! Neprozrazujte dobré zprávy hned, budete mít víc energie
- Proč se u nás v poslední době tak rozšířila pertuse?
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Není statin jako statin aneb praktický přehled rozdílů jednotlivých molekul
Nejčtenější v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF
- Pathways to conspiracy: The social and linguistic precursors of involvement in Reddit’s conspiracy theory forum
- Urticating setae of tarantulas (Araneae: Theraphosidae): Morphology, revision of typology and terminology and implications for taxonomy
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy