Early health economic analysis of 1.5 T MRI-guided radiotherapy for localized prostate cancer: Decision analytic modelling

Background and purpose1.5 Tesla magnetic resonance imaging radiotherapy linear accelerator (MR-Linac) is gaining interest for treatment of localized prostate cancer. Clinical evidence lacking it therefore remains uncertain whether MR-Linac cost-effective. An early health economic analysis was performed to calculate the necessary relative reduction in complications maximum price (5 fractions) be cost-effective compared 5, 20 39 fractionation schedules external beam (EBRT) low-dose-rate (LDR) brachytherapy.Materials methodsA state transition model developed men with Complication rates such as grade ≥2 urinary, bowel sexual complications, utilities were based on systematic literature searches. Costs estimated from a Dutch healthcare perspective. Threshold analyses identify thresholds costs cost-effective, while holding other outcomes biochemical progression mortality constant. One-way sensitivity outline uncertainty outcomes.ResultsAt €6460 per patient, no reductions needed consider EBRT fractions. Compared 5 fractions LDR brachytherapy, found when are relatively reduced by 54% 66% respectively. Results highly sensitive probability progression.ConclusionsMR-Linac at baseline. For become over has reduce substantially or offered lower costs.