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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