Cost-Effectiveness Analysis of Prostate-Specific Antigen Screening Among Chinese Men

Abstract

ObjectivesTo analyze the cost-effectiveness of prostate cancer screening among Chinese men. MethodsA cost-effectiveness analysis was performed from a societal perspective using a Markov model to compare 2 strategies: the population-based screening strategy and the current clinical diagnostic strategy. Relevant parameters were retrieved from published literature data and surveys, and univariate sensitivity analysis was used to assess the robustness of the model. We simulated the health outcomes for the next 25 years for 100 000 men and calculated the incremental cost-effectiveness ratio (ICER). ResultsThis study found that the population-based screening strategy, compared with the clinical diagnostic strategy, could save 756.61 quality-adjusted life-years (QALYs) for the hypothetical population. The ICER for the population-based screening strategy was ¥14 747.11/QALY, and this value was less than the willingness-to-pay threshold of ¥64 520. With life-year gains (LYGs) as the model output, the population-based screening strategy yielded an ICER of ¥16 470.45/LYG. The univariate sensitivity analyses showed that the ICER was sensitive to the prostate-specific antigen (PSA) test fee, the proportion diagnosed with low-grade prostate cancer (PC) in the population-based strategy, and the proportion diagnosed with intermediate-grade PC in the population-based strategy. ConclusionsProstate cancer screening based on PSA test results appears to be cost-effective for Chinese men who are in good health and have a life expectancy of more than 10 years. Nevertheless, this finding needs to be further studied with more treatment cost parameters (treatment costs related to impotence and urinary incontinence) and using local utility value information.