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Clinical

Cost-effectiveness of SelectMDx for prostate cancer in four European countries: a comparative modeling study

Prostate Cancer and Prostatic Diseases volume 22, pages 101–109 (2019)Cite this article

Subjects

Abstract

Background

Low specificity of prostate-specific antigen results in a considerable number of unnecessary prostate biopsies in current practice. SelectMDx® predicts significant prostate cancer upon biopsy and is used to reduce the number of unnecessary initial prostate biopsies. Furthermore, potential overtreatment of insignificant prostate cancer can be reduced. Besides the diagnostic accuracy of the test, also the context in a specific country determines the potential health benefit and cost-effectiveness. Therefore, the health benefit and cost-effectiveness of SelectMDx were assessed in France, Germany, Italy, and Spain.

Subject and methods

A decision model was used to compare the current standard of care in which men undergo initial prostate biopsy in case of an elevated prostate-specific antigen, to a strategy in which SelectMDx was used to select men for biopsy. Model inputs most relevant to each of the four countries were obtained. With use of the model long-term quality-adjusted life years (QALYs) and healthcare costs were calculated for both strategies.

Results

In all four countries, the SelectMDx resulted in QALY gain and cost savings compared with the current standard of care. In France, SelectMDx resulted in 0.022 QALYs gained and cost savings of €1217 per patient. For Germany, the model showed a QALY gain of 0.016 and a cost saving of €442. In Italy, the QALY gain and cost savings were 0.031 and €762. In Spain 0.020 QALYs were gained and €250 costs were saved.

Conclusions

The results of the model showed that with SelectMDx, QALYs could be gained while saving healthcare costs in the initial diagnosis of prostate cancer. The significant presence of overtreatment in the current standard of care in all four countries was the main factor that resulted in the beneficial outcomes with SelectMDx.

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Funding

Funding

MDxHealth financially supported this study. Tim Govers performs consultancy work for MDxHealth. Daphne Hessels, Wim van Criekinge, and Jack Schalken are employees or advisors to MDxhealth and may have stock options.

Author information

Author notes

  1. These authors contributed equally: Tim M. Govers and Daphne Hessels.

Authors and Affiliations

  1. MedValue, Nijmegen, The Netherlands

    Tim M. Govers

  2. MDxHealth BV, Nijmegen, The Netherlands

    Daphne Hessels

  3. Medical Unit of Molecular Oncology and Transfer, Department of Biochemistry and Molecular Biology, University Hospital of Lyon-Sud, Hospices Civils of Lyon, Lyon, France

    Virginie Vlaeminck-Guillem

  4. Cancer Research Centre of Lyon, U1052 INSERM, CNRS 5286, Léon Bérard Centre, Lyon I University, Lyon, France

    Virginie Vlaeminck-Guillem

  5. BSD: Urologie24, Nuremberg and Dept. of Urology, Friedrich-Alexander University, Erlangen, Germany

    Bernd J. Schmitz-Dräger

  6. Department of Urology, Ludwig Maximilians-Universität München, Munich, Germany

    Christian G. Stief

  7. Urology department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain

    Claudio Martinez-Ballesteros

  8. Division of Urology, European Institute of Oncology, Milan, Italy

    Matteo Ferro

  9. Department of Urology, Hospital Universitatio Miguel Servet, IIS-Aragón, Zaragoza, Spain

    Angel Borque-Fernando

  10. Department of Urology, Fundación instituto Valenciano, de oncología, Valencia, Spain

    Jose Rubio-Briones

  11. Department of Urology, Radboudumc, Nijmegen, The Netherlands

    J. P. Michiel Sedelaar

  12. Department of Mathematical Modelling, Statistics and Bioinformatics, Ghent University, Ghent, Belgium

    Wim van Criekinge

  13. Department of Urology, Radboudumc, Nijmegen, The Netherlands

    Jack A. Schalken

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  1. Tim M. Govers
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  2. Daphne Hessels
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  3. Virginie Vlaeminck-Guillem
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  5. Christian G. Stief
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  6. Claudio Martinez-Ballesteros
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  7. Matteo Ferro
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  10. J. P. Michiel Sedelaar
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  11. Wim van Criekinge
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  12. Jack A. Schalken
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Corresponding author

Correspondence to Tim M. Govers.

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Govers, T.M., Hessels, D., Vlaeminck-Guillem, V. et al. Cost-effectiveness of SelectMDx for prostate cancer in four European countries: a comparative modeling study. Prostate Cancer Prostatic Dis 22, 101–109 (2019). https://doi.org/10.1038/s41391-018-0076-3

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