The proPSMA trial at ten Australian centers demonstrated increased sensitivity and specificity for PSMA PET/CT compared to conventional imaging regarding metastatic status in primary high-risk prostate cancer patients. A cost-effectiveness analysis showed benefits of PSMA PET/CT over conventional imaging for the Australian setting. However, comparable data for other countries are lacking. Therefore, we aimed to verify the cost-effectiveness of PSMA PET/CT in several European countries as well as the USA.
Clinical data on diagnostic accuracy were derived from the proPSMA trial. Costs for PSMA PET/CT and conventional imaging were taken from reimbursements of national health systems and individual billing information of selected centers in Belgium, Germany, Italy, the Netherlands, and the USA. For comparability, scan duration and the decision tree of the analysis were adopted from the Australian cost-effectiveness study.
In contrast to the Australian setting, PSMA PET/CT was primarily associated with increased costs in the studied centers in Europe and the USA. Mainly, the scan duration had an impact on the cost-effectiveness. However, costs for an accurate diagnosis using PSMA PET/CT seemed reasonably low compared to the potential consequential costs of an inaccurate diagnosis.
We assume that the use of PSMA PET/CT is appropriate from a health economic perspective, but this will need to be verified by a prospective evaluation of patients at initial diagnosis.
European journal of nuclear medicine and molecular imaging. 2023 Jul 10 [Epub ahead of print]
Adrien Holzgreve, Marcus Unterrainer, Jérémie Calais, Thaiza Adams, Daniela E Oprea-Lager, Karolien Goffin, Egesta Lopci, Lena M Unterrainer, Kristina K M Kramer, Nina-Sophie Schmidt-Hegemann, Jozefina Casuscelli, Christian G Stief, Jens Ricke, Peter Bartenstein, Wolfgang G Kunz, Dirk Mehrens
Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany. ., Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, California, Los Angeles, USA., Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands., Division of Nuclear Medicine, University Hospital Leuven and KU Leuven, Leuven, Belgium., Nuclear Medicine Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy., Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany.