Period of follow-up; strategy | % | Mean cost per patient (95% CI),† $ | Cost difference (immediate treatment v. active surveillance) | |||
---|---|---|---|---|---|---|

Mortality* | Recurrence* | Discount* | Absolute, $ | Relative, % | ||

Model integrating assumptions derived from Keegan et al. (23)‡ | ||||||

First year and 5-year follow-up | ||||||

Active surveillance | 0 | 0 | — | 5 855 (5 780–5 930) | 6 416 | 52.3 |

0 | 0 | 5 | 5 474 (5 408–5 539) | 6 237 | 53.3 | |

Immediate treatment | 0 | 0 | — | 12 271 (12 161–12 381) | ||

0 | 0 | 5 | 11 711 (11 625–11 798) | |||

First year and 10-year follow-up | ||||||

Active surveillance | 0 | 0 | — | 9 201 (9 069–9 334) | 5 843 | 38.8 |

0 | 0 | 5 | 7 673 (7 584–7 763) | 6 165 | 44.6 | |

Immediate treatment | 0 | 0 | — | 15 044 (14 806–15 282) | ||

0 | 0 | 5 | 13 838 (13 679–13 997) | |||

Model with discount rates of 3% and 10% | ||||||

First year and 5-year follow-up | ||||||

Active surveillance | 3.8 | 13.9 | 3 | 5 810 (5 701–5 920) | 7 496 | 56.3 |

3.8 | 13.9 | 10 | 5 134 (5 039–5 230) | 7 367 | 58.9 | |

Immediate treatment | 3.8 | 2.57 | 3 | 13 306 (13 199–13 413) | ||

3.8 | 2.57 | 10 | 12 501 (12 417–12 586) | |||

First year and 10-year follow-up | ||||||

Active surveillance | 3.8 | 13.9 | 3 | 9 438 (9 246–9 629) | 7 601 | 44.6 |

3.8 | 13.9 | 10 | 7 357 (7 214–7 499) | 7 239 | 49.6 | |

Immediate treatment | 3.8 | 2.57 | 3 | 17 039 (16 836–17 242) | ||

3.8 | 2.57 | 10 | 14 596 (14 461–14 731) | |||

Model with 15 years of follow-up | ||||||

Active surveillance | 3.8§; 8.16¶ | 13.9 | — | 14 806 (14 480–15 132) | 8 063 | 35.3 |

3.8§; 8.16¶ | 13.9 | 5 | 11 082 (10 853–11 311) | 7 013 | 38.8 | |

Immediate treatment | 3.8§; 8.16¶ | 2.57 | — | 22 869 (22 511–23 227) | ||

3.8§; 8.16¶ | 2.57 | 5 | 18 095 (17 864–18 324) |

Note: CI = confidence interval. *Yearly rate. †The 95% CI of the mean cost was obtained by the simulation of 1000 samples of equal sample size of 12 750 patients. ‡The assumptions are as follows: 1) 2 additional biopsies in the first 5-year period of follow-up; 2) rate of death and rate of recurrence, both set to 0; 3) probability of receiving each specific treatment assumed to be 0.4 for radical prostatectomy, 0.25 for intensity-modulated radiotherapy, 0.1 for intensity-modulated radiotherapy plus androgen deprivation therapy, 0.15 for brachytherapy and 0.1 for androgen deprivation therapy; and 4) probability of receiving delayed treatment of 7% per year, in the first 5 years of follow-up, and 4.5% per year in the following 5-year period. §Years 1 to 10. ¶Years 11 to 15.