Cost-utility analysis of prostatic artery embolization for treatment of lower urinary tract symptoms
Fecha
2023Autor
Versión
Acceso abierto / Sarbide irekia
Tipo
Artículo / Artikulua
Versión
Versión aceptada / Onetsi den bertsioa
Impacto
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10.1007/s00270-023-03443-9
Resumen
Purpose: To perform a post hoc cost–utility analysis of a
randomized controlled clinical trial comparing prostatic
artery embolization (PAE) and transurethral resection of
the prostate (TURP) in patients with lower urinary tract
symptoms secondary to benign prostatic hyperplasia.
Materials and Methods: We conducted a cost–utility analysis
over a 5-year period to compare PAE versus TURP from ...
[++]
Purpose: To perform a post hoc cost–utility analysis of a
randomized controlled clinical trial comparing prostatic
artery embolization (PAE) and transurethral resection of
the prostate (TURP) in patients with lower urinary tract
symptoms secondary to benign prostatic hyperplasia.
Materials and Methods: We conducted a cost–utility analysis
over a 5-year period to compare PAE versus TURP from a
Spanish National Health System perspective. Data were collected from a randomized clinical trial performed at a single
institution. Effectiveness was measured as quality-adjusted
life years (QALYs), and an incremental cost-effectiveness
ratio (ICER) was derived from the cost and QALY values
associated with these treatments. Further sensitivity analysis
was performed to account for the impact of reintervention on
the cost-effectiveness of both procedures.
Results: At the 1-year follow-up, PAE resulted in mean cost
per patient of €2904.68 and outcome of 0.975 QALYs per
treatment. In comparison, TURP had cost €3846.72 per
patient and its outcome was 0.953 QALYs per treatment. At
5 years, the cost for PAE and TURP were €4117.13 and
€4297.58, and the mean QALY outcome was 4.572 and
4.487, respectively. Analysis revealed an ICER of €2121.15
saved per QALY gained when comparing PAE to TURP at
long-term follow-up. Reintervention rate for PAE and TURP
was 12% and 0%, respectively.
Conclusions: Compared to TURP, in short term, PAE could
be considered a cost-effective strategy within the Spanish
healthcare system for patients with lower urinary tract
symptoms secondary to benign prostatic hyperplasia.
However, in long term, the superiority is less apparent due
to higher reintervention rates. [--]
Materias
Benign prostatic hyperplasia,
Cost-effectiveness,
Prostatic artery embolization (PAE),
Transurethral resection of the prostate (TURP)
Publicado en
CardioVascular and Interventional Radiology (2023), 46(8), 1025–1035
Departamento
Universidad Pública de Navarra. Departamento de Ciencias de la Salud /
Nafarroako Unibertsitate Publikoa. Osasun Zientziak Saila /
Universidad Pública de Navarra. Departamento de Economía /
Nafarroako Unibertsitate Publikoa. Ekonomia Saila