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dc.contributor.authorSathianathen, Niranjan J-
dc.contributor.authorKuntz, Karen M-
dc.contributor.authorAlarid-Escudero, Fernando-
dc.contributor.authorLawrentschuk, Nathan L-
dc.contributor.authorBolton, Damien M-
dc.contributor.authorMurphy, Declan G-
dc.contributor.authorWeight, Christopher J-
dc.contributor.authorKonety, Badrinath R-
dc.identifier.citationThe Journal of Urology 2018; online first: 12 June-
dc.description.abstractTo perform a cost-effectiveness analysis of using Prostate Health Index (PHI), 4Kscore, SelectMDx and ExoDx Prostate IntelliScore (EPI) in men with an elevated PSA value to determine the need for biopsy. We developed a decision-analytic model for men with an elevated PSA values (≥ 3ng/mL) where one of the biomarker tests was to determine which hypothetical individuals required a biopsy. In the current standard of care strategy, all individuals underwent a biopsy. Model parameters were derived from a comprehensive review of the literature. Costs were calculated from a health sector perspective and converted into 2017 US dollars. The cost and QALYs of the current standard of care (transrectal ultrasound guided biopsy) was $3,863 and 18.085, respectively. The use of any of the three biomarkers improved quality-adjusted survival compared to the current standard of care. The cost of SelectMDx, PHI and EPI was lower than performing a prostate biopsy on all patients. However, PHI was more costly and less effective than the SelectMDx strategy. EPI provided the highest QALY with an incremental cost-effectiveness ratio of $58,404 per QALY. The use of biomarkers could reduce the number of unnecessary biopsies by 24-34% compared to the current standard of care. The use of biomarkers in men with an elevated PSA to determine the need for biopsy improves quality-adjusted survival by decreasing the number of biopsies performed and treatment of indolent disease. Obtaining a SelectMDx or EPI following an elevated PSA but before proceeding to a biopsy are cost-effective strategies in this setting.-
dc.subjectcost analysis-
dc.subjectcost savings-
dc.subjectdecision making-
dc.subjectProstate cancer-
dc.titleIncorporating biomarkers into the primary prostate biopsy setting: a cost-effectiveness analysis.-
dc.typeJournal Article-
dc.identifier.journaltitleThe Journal of urology-
dc.identifier.affiliationDepartment of Urology, University of Minnesota, Minneapolis, Minnesota, USA-
dc.identifier.affiliationDepartment of Surgery, Urology Unit, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia-
dc.identifier.affiliationOlivia Newton John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia-
dc.identifier.affiliationDivision of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States-
dc.identifier.affiliationDepartment of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia-
Appears in Collections:Journal articles

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