title: Cost-effectiveness analysis of intensity-modulated radiation therapy with normal and hypofractionated schemes for the treatment of localised prostate cancer.
abstract: The aim of our analysis was to compare the cost-effectiveness of high-dose intensity-modulated radiation therapy (IMRT) and hypofractionated intensity-modulated radiation therapy (HF-IMRT) versus conventional dose three-dimensional radiation therapy (3DCRT) for the treatment of localised prostate cancer. A Markov model was constructed to calculate the incremental quality-adjusted life years and costs. Transition probabilities, adverse events and utilities were derived from relevant systematic reviews. Microcosting in a large university hospital was applied to calculate cost vectors. The expected mean lifetime cost of patients undergoing 3DCRT, IMRT and HF-IMRT were 7,160 euros, 6,831 euros and 6,019 euros respectively. The expected quality-adjusted life years (QALYs) were 5.753 for 3DCRT, 5.956 for IMRT and 5.957 for HF-IMRT. Compared to 3DCRT, both IMRT and HF-IMRT resulted in more health gains at a lower cost. It can be concluded that high-dose IMRT is not only cost-effective compared to the conventional dose 3DCRT but, when used with a hypofractionation scheme, it has great cost-saving potential for the public payer and may improve access to radiation therapy for patients.
authors.affiliation: Institute for Health Insurance, University of Pécs, Mária u. 5-7., Pécs, Hungary.
authors.forename: A T
authors.initials: AT
authors.lastname: Zemplényi
authors.affiliation: Department of Health Policy and Economics, Eötvös Loránd University, Pázmány Péter sétány 1/a., Budapest, Hungary.
authors.forename: Z
authors.initials: Z
authors.lastname: Kaló
authors.affiliation: Syreon Research Center, Thököly út 119., Budapest, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Kovács
authors.affiliation: Medical Center of the University of Pécs, Oncology Center, Édesanyák útja 17., Pécs, Hungary.
authors.forename: R
authors.initials: R
authors.lastname: Farkas
authors.affiliation: Medical Center of the University of Pécs, Urology Clinic, Munkácsy M. u. 2., Pécs, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Beöthe
authors.affiliation: Urology Clinic, Medical Center of the University of Pécs, Munkácsy M. u. 2., Pécs, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Bányai
authors.affiliation: Medical Center of the University of Pécs, Oncology Center, Édesanyák útja 17., Pécs, Hungary.
authors.forename: Z
authors.initials: Z
authors.lastname: Sebestyén
authors.affiliation: Institute for Health Insurance, University of Pécs, Mária u. 5-7., Pécs, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Endrei
authors.affiliation: Institute for Health Insurance, University of Pécs, Mária u. 5-7., Pécs, Hungary.
authors.forename: I
authors.initials: I
authors.lastname: Boncz
authors.affiliation: Medical Center of the University of Pécs, Oncology Center, Édesanyák útja 17., Pécs, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Mangel
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008390:Markov Chains; D011471:Prostatic Neoplasms / Q000191:economics* / Q000532:radiotherapy*; D019057:Quality-Adjusted Life Years; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000191:economics / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000191:economics / Q000379:methods; D012307:Risk Factors
keywords: cost-effectiveness analysis; hypofractionation; prostate cancer; radiotherapy