Figure Markov transition states A comparison of the economic model presented in this assessment (CA 1397) and the economic model presented by Gordon et al. (2016) is provided in Table 54. The main differences between the models are the number of health states and perspectives presented. The economic evaluation presented by Gordon et al. (2016) presented 20 health states (17 health states for patients with PCa, and 3 additional states for patients undergoing screening) and in this assessment 5 health states are presented. Gordon et al. (2016) included out-of-pocket costs for patients, whereas this assessment only takes the perspective of the MBS. The key structural assumptions are the same; mean age of the cohort is 65-66 years, time horizon applied for a lifetime up to age 90 years, costs and benefits are discounted at 5 per cent. Table Comparison of key economic evaluations: CA 1397 and Gordon et al. (2016) CA 1397 Gordon et al. 2016 Perspective MBS, health care system (Australia) Health care system (Australia); Out of pocket costs for patients. Population Population 1 Population 1 Men with suspected PCa. Men with suspected PCa who have not had a prior biopsy. Population 2 Men with low to intermediate risk PCa in AS. Interventions mpMRI ± TRUSGB/TPUSGB [75%:25%] Strategy 2: mpMRI ± MRIGB Strategy 3: mpMRI ± (MRIGB or TRUSGB or TPUSGB) [33.3% of each type of biopsy] Comparator TRUSGB/TPUSGB Strategy 1: TRUSGB Type of CEA and CUA CEA and CUA economic evaluation Sources of Systematic review and meta-analysis of clinical Systematic literature review evidence trials (presented in Section B) Time horizon Lifetime time horizon (25 years) in the model Lifetime: ~30 years, maximum is when men reach age 90 unless they die earlier. Outcomes No. of biopsies No. of biopsies Costs Costs QALYs LYs QALYs Methods used Combined decision tree and Markov model using Markov model using cohort expected value to generate cohort expected value analysis analysis results The base model consisted of 17 health states Health states No prostate cancer (Markov model), which was altered to address Low to intermediate risk prostate cancer research question and included additional health (insignificant cancer) states (n=3): Intermediate to high risk prostate cancer
Figure Markov transition states A comparison of the economic model presented in this assessment (CA 1397) and the economic model presented by Gordon et al. (2016) is provided in Table 54. The main differences between the models are the number of health states and perspectives presented. The economic evaluation presented by Gordon et al. (2016) presented 20 health states (17 health states for patients with PCa, and 3 additional states for patients undergoing screening) and in this assessment 5 health states are presented. Gordon et al. (2016) included out-of-pocket costs for patients, whereas this assessment only takes the perspective of the MBS. The key structural assumptions are the same; mean age of the cohort is 65-66 years, time horizon applied for a lifetime up to age 90 years, costs and benefits are discounted at 5 per cent. Table Comparison of key economic evaluations: CA 1397 and Gordon et al. (2016) CA 1397 Gordon et al. 2016 Perspective MBS, health care system (Australia) Health care system (Australia); Out of pocket costs for patients. Population Population 1 Men with suspected PCa. Population 2 Men with low to intermediate risk PCa in AS. Population 1 Men with suspected PCa who have not had a prior biopsy. Interventions mpMRI ± TRUSGB/TPUSGB [75%:25%] Strategy 2: mpMRI ± MRIGB Strategy 3: mpMRI ± (MRIGB or TRUSGB or TPUSGB) [33.3% of each type of biopsy] Comparator TRUSGB/TPUSGB Strategy 1: TRUSGB Type of economic evaluation CEA and CUA CEA and CUA Sources of evidence Systematic review and meta-analysis of clinical trials (presented in Section B) Systematic literature review Time horizon Lifetime time horizon (25 years) in the model Lifetime: ~30 years, maximum is when men reach age 90 unless they die earlier. Outcomes No. of biopsies Costs QALYs No. of biopsies Costs LYs QALYs Methods used to generate results Combined decision tree and Markov model using cohort expected value analysis Markov model using cohort expected value analysis Health states No prostate cancer Low to intermediate risk prostate cancer (insignificant cancer) Intermediate to high risk prostate cancer The base model consisted of 17 health states (Markov model), which was altered to address research question and included additional health states (n=3):
1397_Final_MSAC_Assessment_Report.docx