Objectives: With the growing development of techniques using personalized medicine (PM) in oncology, cancers can be diagnosed and treated faster. Consequently, it is important to develop specific tools to assess the economic impact of these new technologies. Thus, this study aims to develop a global economic model to assess the cost-effectiveness of screening for prostate cancer (PC) using PM. Method(s): Literature reviews were conducted to identify economic studies in PC and to retrieve studies of pharmacogenomics tests used in PC. Data from these reviews were used for the development of key assumptions and parameters of the global economic model. This model includes a decision tree used to assess the economic impact of screening for PC using PM from a provincial Ministry of Health (MoH) and a societal perspective over a lifetime horizon. Parameters considered in the model were the characteristics of the biomarker, probability of developing PC, PC prognosis characteristics, direct costs (screening tests, biopsy, treatment), indirect costs, health utilities and disutilities. Values were extracted from literature and governmental publications. The model was tested using the prostate specific antigen test (PSA) in addition to the standard test (DRE) to screen for PC compared to DRE alone. Result(s): When tested, total cost reduction was -$300.08 and -$1,313 from a MoH and a societal perspective respectively, for a total QALY gain of 0.15 per patient, which lead to a dominant strategy for PSA testing in addition to DRE compared to DRE alone. PSA testing in addition to DRE remained a dominant strategy over DRE alone in all scenarios tested in sensitivity analyses. Conclusion(s): This model could help Canadian agencies for reimbursement decision of PM testing, as the global economic model can assess on a similar basis the economic impact of several strategies in PC screening using PM.
Piché-Richard, Mathurin, K., Savoie, M., & Lachaine, J. (2016). Development of a Global Model for the Economic Evaluation of Personalized Medicine for the Treatment of Prostate Cancer. Value in Health, 19(7), A740. https://doi.org/10.1016/j.jval.2016.09.2250