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Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review

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dc.contributor.author Becerra Bachino, Virginia, 1975-
dc.contributor.author Ávila Pacheco, Mónica Marcela, 1984-
dc.contributor.author Jiménez Conde, Jordi
dc.contributor.author Cortes-Sanabria, Laura
dc.contributor.author Pardo Cladellas, Yolanda
dc.contributor.author Garin Boronat, Olatz, 1979-
dc.contributor.author Pont Acuña, Àngels
dc.contributor.author Alonso Caballero, Jordi
dc.contributor.author Cots Reguant, Francesc
dc.contributor.author Ferrer Forés, Maria Montserrat
dc.contributor.author Multicentric Spanish Group of Clinically Localized Prostate Cancer
dc.date.accessioned 2016-10-10T14:20:28Z
dc.date.available 2016-10-10T14:20:28Z
dc.date.issued 2016
dc.identifier.citation Becerra V, Ávila M, Jimenez J, Cortes-Sanabria L, Pardo Y, Garin O et al. Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review. BMC Health Serv Res. 2016 Oct 3;16(1):541. DOI: 10.1186/s12913-016-1781-z
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10230/27398
dc.description.abstract Background: Our objective was to assess the efficiency of treatments in patients with localized prostate cancer, by synthesizing available evidence from European economic evaluations through systematic review. Methods: Articles published 2000–2015 were searched in MEDLINE, EMBASE and NHS EED (Prospero protocol CRD42015022063). Two authors independently selected studies for inclusion and extracted the data. A third reviewer resolved discrepancies. We included European economic evaluations or cost comparison studies, of any modality of surgery or radiotherapy treatments, regardless the comparator/s. Drummond’s Checklist was used for quality assessment./nResults: After reviewing 8,789 titles, 13 European eligible studies were included: eight cost-utility, two cost-effectiveness, one cost-minimization, and two cost-comparison analyses. Of them, five compared interventions with expectant management, four contrasted robotic with non robotic-assisted surgery, three assessed new modalities of radiotherapy, and three compared radical prostatectomy with brachytherapy. All but two studies scored ≥8 in the quality checklist. Considering scenario and comparator, three interventions were qualified as dominant strategies (active surveillance, robotic-assisted surgery and IMRT), and six were cost-effective (radical prostatectomy, robotic-assisted surgery, IMRT, proton therapy, brachytherapy, and 3DCRT). However, QALY gains in most of them were small. For interventions considered as dominant strategies, QALY gain was 0.013 for active surveillance over radical prostatectomy; and 0.007 for robotic-assisted over non-robotic techniques. The highest QALY gains were 0.57–0.86 for radical prostatectomy vs watchful waiting, and 0.72 for brachytherapy vs conventional radiotherapy. Conclusions: Currently, relevant treatment alternatives for localized prostate cancer are scarcely evaluated in Europe. Very limited available evidence supports the cost-effectiveness of radical prostatectomy over watchful waiting, brachytherapy over radical prostatectomy, and new treatment modalities over traditional procedures. Relevant disparities were detected among studies, mainly based on effectiveness. These apparently contradictory results may be reflecting the difficulty of interpreting small differences between treatments regarding QALY gains.
dc.description.sponsorship Financial support for this study was provided by Instituto de Salud Carlos III FEDER: Fondo Europeo de Desarrollo Regional (FIS PI08/90090 and PI13/00412); Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS), 436/05/2008; Ministerio de Ciencia e Innovación (PTAT2011-04891); and DIUE of Generalitat de Catalunya (2014 SGR 748). The funding agreements ensure the authors’ independence in designing the study, interpreting the data, and writing and publishing the report.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartof BMC Health Serv Res. 2016 Oct 3;16(1):541
dc.rights © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
dc.subject.other Pròstata -- Càncer
dc.title Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1186/s12913-016-1781-z
dc.subject.keyword Cost-effectiveness analysis
dc.subject.keyword Cost-utility analysis
dc.subject.keyword Cost-benefit analysis
dc.subject.keyword Prostatic neoplasms
dc.subject.keyword QALY Quality-adjusted life years
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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