PURPOSE: The purpose of this study is to compare the cost-effectiveness of two external beam radiation therapy techniques for treatment of low- to intermediate-risk prostate cancer: stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT). MATERIALS AND METHODS: A Markov decision analysis model with probabilistic sensitivity analysis was designed with the various disease states of a 70-year-old patient with organ-confined prostate cancer to evaluate the cost-effectiveness of two external beam radiation treatment options. RESULTS: The Monte Carlo simulation revealed that the mean cost and quality-adjusted life-years (QALYs) for SBRT and IMRT were $22,152 and 7.9 years and $35,431 and 7.9 years, respectively. The sensitivity analysis revealed that if the SBRT cohort experienced a decrease in quality of life of 4% or a decrease in efficacy of 6%, then SBRT would no longer dominate IMRT in cost-effectiveness. In fact, with these relaxed assumptions for SBRT, the incremental cost-effectiveness ratio of IMRT met the societal willingness to pay threshold of $50,000 per QALY. CONCLUSION: Compared with IMRT, SBRT for low- to intermediate-risk prostate cancer has great potential cost savings for our health care system payers and may improve access to radiation, increase patient convenience, and boost quality of life for patients. Our model suggests that the incremental cost-effectiveness ratio of IMRT compared with SBRT is highly sensitive to quality-of-life outcomes, which should be adequately and comparably measured in current and future prostate SBRT studies.
PURPOSE: The purpose of this study is to compare the cost-effectiveness of two external beam radiation therapy techniques for treatment of low- to intermediate-risk prostate cancer: stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT). MATERIALS AND METHODS: A Markov decision analysis model with probabilistic sensitivity analysis was designed with the various disease states of a 70-year-old patient with organ-confined prostate cancer to evaluate the cost-effectiveness of two external beam radiation treatment options. RESULTS: The Monte Carlo simulation revealed that the mean cost and quality-adjusted life-years (QALYs) for SBRT and IMRT were $22,152 and 7.9 years and $35,431 and 7.9 years, respectively. The sensitivity analysis revealed that if the SBRT cohort experienced a decrease in quality of life of 4% or a decrease in efficacy of 6%, then SBRT would no longer dominate IMRT in cost-effectiveness. In fact, with these relaxed assumptions for SBRT, the incremental cost-effectiveness ratio of IMRT met the societal willingness to pay threshold of $50,000 per QALY. CONCLUSION: Compared with IMRT, SBRT for low- to intermediate-risk prostate cancer has great potential cost savings for our health care system payers and may improve access to radiation, increase patient convenience, and boost quality of life for patients. Our model suggests that the incremental cost-effectiveness ratio of IMRT compared with SBRT is highly sensitive to quality-of-life outcomes, which should be adequately and comparably measured in current and future prostate SBRT studies.
Authors: Andre Konski; Deborah Watkins-Bruner; Steven Feigenberg; Alexandra Hanlon; Sachin Kulkarni; J Robert Beck; Eric M Horwitz; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2006-08-02 Impact factor: 7.038
Authors: Deborah A Kuban; Susan L Tucker; Lei Dong; George Starkschall; Eugene H Huang; M Rex Cheung; Andrew K Lee; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2007-08-31 Impact factor: 7.038
Authors: Kathleen W Beekman; Mark T Fleming; Howard I Scher; Susan F Slovin; Nicole M Ishill; Glenn Heller; W Kevin Kelly Journal: Clin Prostate Cancer Date: 2005-09
Authors: Michael J Zelefsky; Zvi Fuks; Margie Hunt; Yoshiya Yamada; Christine Marion; C Clifton Ling; Howard Amols; E S Venkatraman; Steven A Leibel Journal: Int J Radiat Oncol Biol Phys Date: 2002-08-01 Impact factor: 7.038
Authors: Scott C Morgan; Karen Hoffman; D Andrew Loblaw; Mark K Buyyounouski; Caroline Patton; Daniel Barocas; Soren Bentzen; Michael Chang; Jason Efstathiou; Patrick Greany; Per Halvorsen; Bridget F Koontz; Colleen Lawton; C Marc Leyrer; Daniel Lin; Michael Ray; Howard Sandler Journal: J Clin Oncol Date: 2018-10-11 Impact factor: 44.544
Authors: Scott M Glaser; Ronny Kalash; Dante R Bongiorni; Mark S Roberts; Goundappa K Balasubramani; Bruce L Jacobs; Sushil Beriwal; Dwight E Heron; Joel S Greenberger Journal: In Vivo Date: 2018 Jan-Feb Impact factor: 2.155
Authors: James B Yu; Laura D Cramer; Jeph Herrin; Pamela R Soulos; Arnold L Potosky; Cary P Gross Journal: J Clin Oncol Date: 2014-03-10 Impact factor: 44.544
Authors: William C Jackson; Jessica Silva; Holly E Hartman; Robert T Dess; Amar U Kishan; Whitney H Beeler; Laila A Gharzai; Elizabeth M Jaworski; Rohit Mehra; Jason W D Hearn; Todd M Morgan; Simpa S Salami; Matthew R Cooperberg; Brandon A Mahal; Payal D Soni; Samuel Kaffenberger; Paul L Nguyen; Neil Desai; Felix Y Feng; Zachary S Zumsteg; Daniel E Spratt Journal: Int J Radiat Oncol Biol Phys Date: 2019-04-06 Impact factor: 7.038