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The Value of a New Diagnostic Test for Prostate Cancer: A Cost-Utility Analysis in Early Stage of Development


  • Adam Fridhammar

    (IHE, The Swedish Institute for Health Economics)

  • Ulrika Axelsson

    (Lund University)

  • Ulf Persson

    (IHE, The Swedish Institute for Health Economics)

  • Anders Bjartell

    (Lund University)

  • Carl A. K. Borrebaeck

    (Lund University)


Background Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer diagnosis, treatments and prostate cancer deaths. The analysis was performed from a health care perspective. It used epidemiologic data, treatment patterns, and health care costs from the Swedish region Skåne (population of 1.3 million). A 90% sensitivity and specificity of the new test was assumed. Results Among 31,250 men, age 50–69 years, 16.4% had a PSA between 3.0 and 9.9 µg/L and 28.9% a PSA of 2.0–9.9 µg/L. Testing men with PSA 3.0–9.9 µg/L, as in current clinical practice, decreased the number of biopsies by 3595, detected 61 more cancers, resulting in and two more fatalities and subsequently a loss of 14 QALYs. Cost offsets could justify a test value of SEK 4996. Testing a larger population, PSA 2.0–9.9 µg/L prevented 6 deaths, added 50 QALYs, and could justify a value of the test of SEK 5165, given a value of health of SEK 500,000 per QALY. Conclusion A new blood-based test for prostate cancer has a significant potential to reduce the number of biopsies needed, resulting in reduced health care costs and improve patient care.

Suggested Citation

  • Adam Fridhammar & Ulrika Axelsson & Ulf Persson & Anders Bjartell & Carl A. K. Borrebaeck, 2021. "The Value of a New Diagnostic Test for Prostate Cancer: A Cost-Utility Analysis in Early Stage of Development," PharmacoEconomics - Open, Springer, vol. 5(1), pages 77-88, March.
  • Handle: RePEc:spr:pharmo:v:5:y:2021:i:1:d:10.1007_s41669-020-00226-7
    DOI: 10.1007/s41669-020-00226-7

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    References listed on IDEAS

    1. Susanne Hartz & Jürgen John, 2007. "The contribution of economic evaluation to decision-making in early phases of product development: a methodological and empirical review," Jena Economic Research Papers 2007-094, Friedrich-Schiller-University Jena.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Journal round-up: PharmacoEconomics – Open 5(1)
      by Rita Faria in The Academic Health Economists' Blog on 2021-04-29 06:00:05

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