Evidence map›Paper›PMID 22777393›Full record

ArticleProstate cancer and prostatic diseases2012

Does variation in either age at start of therapy or duration of therapy make chemoprevention with finasteride cost-effective?

S B Stewart, C D Scales, J W Moul, S D Reed

Open access · greenAbstract read
In one paragraph

Article in Prostate cancer and prostatic diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 86% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 9 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

S B StewartDivision of Urology, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. suzanne.stewart@duke.edu
C D Scales
J W Moul
S D Reed
Duke University · USDuke University Hospital · US

Funding

Clinical validity and utility of genomic targeted chemoprevention of PCaRC2CA148463 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI XU, JIANFENG · 2009 to 2009
$2.0M
NCI NIH HHS RC2 CA148463NCI NIH HHS RC2CA148463
6 · The paper itself

Abstract

backgroundIncremental cost-effectiveness ratios (ICERs) of finasteride for prostate cancer prevention are consistent with estimates beyond $100 000 per quality-adjusted life-year (QALY). The majority of these analyses are based on chemoprevention starting in men aged 50-55 years. We sought to evaluate the impact of varying both age at commencement of therapy and length of therapy on the cost-effectiveness of finasteride.

methodsA probabilistic Markov model was designed to estimate lifetime prostate health-related costs and quality-adjusted survival for men receiving or not receiving chemoprevention with finasteride. ICERs across scenarios varying age at start of therapy and duration of chemoprevention were compared.

resultsThe ICER for men starting chemoprevention at age 50 and continuing to age 75 was $88 800 per QALY when assuming finasteride causes a constant risk reduction across all tumor grades (base case 1) and $142 300 per QALY when assuming a differential treatment effect according to Gleason score (base case 2). When starting age is increased, the ICERs trend downward and nadir at 65 years to $64 700 per QALY (base case 1) and $118 600 per QALY (base case 2). Altering duration of therapy had minimal impact. Patient-level experiences with finasteride and BPH significantly influenced the cost-effectiveness of chemoprevention.

conclusionsInitiating chemoprevention at ages when prostate cancer incidence is higher improves its cost-effectiveness profile. Only when assuming a constant risk reduction for all tumor grades, did finasteride fall below $100 000 per QALY, but this finding was not upheld when accounting for side effects associated with the drug.

Indexed as

Age FactorsMarkov ChainsAgedChemopreventionCost-Benefit AnalysisFinasterideHealth Care CostsHumansMaleMiddle AgedProstatic NeoplasmsQuality-Adjusted Life YearsFinasteride

Identifiers

PMID22777393
PMCPMC3666586
OpenAlexW2037184900

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.