Table 4 Main findings of Cost-effectiveness studies comparing IMRT, SBRT and PBT for localized prostate cancer
Study (authors, year) | Result | Conclusions | ||
|---|---|---|---|---|
Mean cost | QALYs | ICER | ||
Hodges et al. (2012) [19] | SBRT: $22,152 IMRT: $35,431 | SBRT = 7.9 IMRT = 7.9 | NA | “Compared with IMRT, SBRT for low- to intermediate-risk prostate cancer has great potential cost savings” |
Sher et al. (2014) [20] | IMRT: $27,564 Non-robotic SBRT: $10,108 Cyber-knife SBRT: $19,275 | IMRT: 9.96 SBRT: 9.93 | IMRT vs robotic SBRT: $285,000/QALY IMRT vs Non- robotic: US$591,100/QALY | “SBRT clearly contained more value than IMRT for external-beam treatment” |
Parthan et al. (2012) [18] | Payer perspective IMRT: $33,068 PBT: $69,412 SBRT: $24,873 Societal perspective SBRT: $25,097, IMRT: $35,088 PBT: $71,657 | SBRT: 8.11 IMRT: 8.05 PBT: 8.06 | SBRT was dominating over RT and IMRT (less costly and more QALYs) | “Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer” |
Lundkvist, et al. (2005) [21] | Proton: €13,491 IMRT: €5477 | Cost Standard case result: 7952.6 High proton radiation cost estimate: 10,485.2 Low proton radiation cost estimate: 7343.9 | QALY Standard case result: 0.297 High proton radiation cost estimate: 0.297 Low proton radiation cost estimate: 0.297 | “Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used” |
Konski et al. (2007) [22] | 70-year-old man PBT: $63,511 IMRT: $36,808 60-year-old man PBT: $64,989 IMRT: $39,355 | 70-year-old man PBT: 8.54 IMRT: 8.12 60-year-old man PBT: 9.91 IMRT: 9.45 | 70-year-old man $63,578/QALY 60-year-old man $55,726/QALY | “Even when based on the unproven assumption that protons will permit a 10-Gy escalation of prostate dose compared with IMRT photons, proton beam therapy is not cost effective for most patients with prostate cancer using the commonly accepted standard of $50,000/QALY” |