title: Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.
abstract: OBJECTIVE
  Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice.
  
  
  METHODS
  A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon.
  
  
  RESULTS
  Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted.
  
  
  CONCLUSIONS
  This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.
authors.affiliation: National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland. a.pearce@ncri.ie.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Pearce
authors.affiliation: University of Sheffield, Western Bank, Sheffield, S10 2TN, UK.
authors.forename: Fay
authors.initials: F
authors.lastname: Ryan
authors.affiliation: National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Drummond
authors.affiliation: National University Ireland, Galway, University Road, Galway, Ireland.
authors.forename: Audrey Alforque
authors.initials: AA
authors.lastname: Thomas
authors.affiliation: National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
authors.forename: Aileen
authors.initials: A
authors.lastname: Timmons
authors.affiliation: National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D008297:Male; D018803:Models, Economic; D010818:Practice Patterns, Physicians' / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics* / Q000628:therapy
keywords: Cancer survivorship; Clinical practice guidelines; Cost minimisation; Economic model; Follow-up; Prostate cancer