Gesundheitsökonomische Evaluation der Magnetresonanzbildgebung im Staging von Prostatakarzinomen für Österreich und Deutschland

Abstract

The aim of this study was the health economics analysis of MR imaging in the preoperative staging of patients with prostate carcinoma (PCa). The health economics analysis consisted of the following steps: modeling, determination of probabilities and parameters based on a detailed literature search, evaluation using the averages of the parameters, and sensitivity analyses of the results over the ranges of values. We performed a cost-utility analysis from health insurance's perspective for Austria and Germany. The population under investigation included patients with confirmed PCa. The alternative was a decision for therapy with or without staging using MR imaging. A localized PCa was treated by prostatectomy and locally advanced PCa by radiation/hormone therapy. The result parameters were quality adjusted life years (QALYs) and costs per patient. The evaluation showed that MR imaging is useful regarding costs and utilities prior to radical prostatectomy which is expensive and may be associated with serious clinical consequences. The costs per patient were lower by € 2635 and the utilities were higher by 0.099 QALYs. The strategy without MR imaging for staging was dominated by the strategy using MR imaging for staging in the evaluation using the base values and in almost all sensitivity analyses. For the parameters used and almost all scenarios of the sensitivity analysis, our decision-analytic model revealed a higher cost-utility ratio for the strategy using MR imaging for the staging of PCa.