Economic Evaluation of Transperineal versus Transrectal Devices for Local Anaesthetic Prostate Biopsies
Authors
Wreford, Alice
Tamer, Priya
Leonard, Kelly
Brechka, Hannah
Gnanapragasam, Vincent J.
Publication Date
2021-07-09Journal Title
PharmacoEconomics - Open
ISSN
2509-4262
Publisher
Springer International Publishing
Volume
5
Issue
4
Pages
737-753
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Wilson, E. C. F., Wreford, A., Tamer, P., Leonard, K., Brechka, H., & Gnanapragasam, V. J. (2021). Economic Evaluation of Transperineal versus Transrectal Devices for Local Anaesthetic Prostate Biopsies. PharmacoEconomics - Open, 5 (4), 737-753. https://doi.org/10.1007/s41669-021-00277-4
Abstract
Abstract: Background: Biopsy of the prostate for suspected cancer is usually performed transrectally under local anaesthesia in the outpatient clinic setting. As this involves piercing the bowel wall, the procedure is associated with a risk of infection. Recently, devices that facilitate transperineal biopsy approaches have been developed that avoid piercing the bowel and so should reduce the risk of infection. Objective: The aim of this study was to estimate the cost effectiveness of transperineal versus transrectal ultrasound-guided local anaesthesia procedures for prostate biopsy from the perspective of the UK NHS and to estimate the value of further research in the area. Methods: a) Decision tree and Markov model synthesising all relevant evidence estimating the life-time costs and QALYs accrued from each biopsy mode. b) Value of information analysis to predict the return from further research and thus guide future research efforts. Results: Transperineal biopsy yields an ICER below £20,000 per QALY gained at a per-procedure device acquisition cost below £81, or £41 for cost-neutrality. These results are driven by differences in consumables cost, reduced cost of treating infections, and QALY gains associated with reduced infections. There is value in future research on the diagnostic accuracy of transperineal versus transrectal biopsies and the incidence of iatrogenic infection and sepsis; consideration should be given to enriching the patient population with men with intermediate-risk disease. Conclusions: Transperineal biopsy devices may be cost effective compared with transrectal biopsy at per-procedure acquisition costs below £81 and cost-neutral if under £41. Future research is required to confirm or refute these findings, particularly randomised comparisons of the diagnostic accuracy and infection risks between the methods.
Keywords
Original Research Article
Sponsorship
Invention for Innovation (II-LB-0716-20001)
Identifiers
s41669-021-00277-4, 277
External DOI: https://doi.org/10.1007/s41669-021-00277-4
This record's URL: https://www.repository.cam.ac.uk/handle/1810/330985
Rights
Licence:
http://creativecommons.org/licenses/by-nc/4.0/
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