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Table 1 Cost-effectiveness results from age and risk stratification analyses

From: Modelling the lifetime cost-effectiveness of radical prostatectomy, radiotherapy and active monitoring for men with clinically localised prostate cancer from median 10-year outcomes in the ProtecT randomised trial

Strategy Mean lifetime cost per patient1 Mean lifetime QALYs per patient1 NMB2 at £20,000 per QALY (95% CI)
Age group < 65 years
 Active monitoring (AM)3 £15,359 15.36 £290,279 (£281,895 to £295,127)
 Radical prostatectomy (RP) £12,939 15.25 £290,487 (£280,781 to £296,281)*
 Radiotherapy (RT) £14,746 15.32 £289,754 (£278,620 to £296,202)
Age group ≥ 65 years
 Active monitoring (AM) £9444 10.23 £194,153 (£186,516 to £199,781)
 Radical prostatectomy (RP)4 £10,283 10.61 £201,052 (£195,294 to £204,579)
 Radiotherapy (RT) £9174 10.57 £201,311 (£195,161 to £205,049)*
D’Amico low risk group
 Active monitoring (AM) £14,027 15.29 £289,965 (£279,855 to £296,013)
 Radical prostatectomy (RP) £12,072 15.25 £290,967 (£279,084 to £297,907)
 Radiotherapy (RT) £11,572 15.34 £293,446 (£282,811 to £299,451)*
D’Amico intermediate/high risk group
 Active monitoring (AM) £18,297 14.30 £265,526 (£247,010 to £278,307)
 Radical prostatectomy (RP) £15,323 14.70 £275,977 (£258,630 to £285,474)*
 Radiotherapy (RT) £15,060 14.35 £268,669 (£246,778 to £282,238)
Grade group - low risk
 Active monitoring (AM) £14,144 15.15 £287,565 (£278,750 to £293,382)
 Radical prostatectomy (RP) £12,055 15.28 £292,198 (£283,797 to £297,258)
 Radiotherapy (RT) £12,041 15.31 £292,736 (£284,074 to £297,719)*
Grade group - intermediate/high risk
 Active monitoring (AM) £17,838 13.90 £256,111 (£226,180 to £276,399)
 Radical prostatectomy (RP) £17,645 14.78 £271,933 (£237,864 to £287,784)*
 Radiotherapy (RT) £16,317 13.54 £248,558 (£207,893 to £274,911)
  1. 1 Deterministic analysis; 2 Probabilistic sensitivity analysis; QALYs (quality adjusted life years); NMB (net monetary benefit); CI (confidence interval) based on the percentile method; 3 AM becomes more cost-effective compared with both RP and RT beyond a willingness-to-pay (WTP) threshold of £24,000 for age subgroup < 65 years (Fig. 2); 4 RP becomes more cost-effective compared with RT beyond a WTP threshold of £28,000 for age subgroup ≥65 years (Fig. 2); *indicates the most cost-effective strategy