Dataset Information

Cost implications of PSA screening differ by age.

ABSTRACT:

Background

Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios.

Methods

We determined the prevalence of PSA screening among men aged 50 and higher using 2013-2014 data from a large, multispecialty group, obtained reimbursed costs associated with screening, diagnosis, and treatment from a commercial health plan, and identified transition probabilities for biopsy, diagnosis, treatment, and complications from the literature to generate a cost model. We estimated annual total costs for groups of men ages 50-54, 55-69, and 70+ years, and varied annual prostate cancer screening prevalence in each group from 5 to 50% and tested hypothetical examples of different test characteristics (e.g., true/false positive rate).

Results

Under the baseline screening patterns, costs of the PSA screening represented 10.1% of the total costs; costs of biopsies and associated complications were 23.3% of total costs; and, although only 0.3% of all screen eligible patients were treated, they accounted for 66.7% of total costs. For each 5-percentage point decrease in PSA screening among men aged 70 and older for a single calendar year, total costs associated with prostate cancer screening decreased by 13.8%. For each 5-percentage point decrease in PSA screening among men 50-54 and 55-69 years old, costs were 2.3% and 7.3% lower respectively.

Conclusions

With constrained financial resources and with national pressure to decrease use of clinically unnecessary PSA-based prostate cancer screening, there is an opportunity for cost savings, especially by focusing on the downstream costs disproportionately associated with screening men 70 and older.

SUBMITTER: Rao K

PROVIDER: S-EPMC5944051 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

Cost implications of PSA screening differ by age.

Rao Karthik K Liang Stella S Cardamone Michael M Joshu Corinne E CE Marmen Kyle K Bhavsar Nrupen N Nelson William G WG Ballentine Carter H H Albert Michael C MC Platz Elizabeth A EA Pollack Craig E CE

BMC urology 20180509 1

<h4>Background</h4>Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios.<h4>Method ...[more]

PMID: 29743049

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Dataset Information

Cost implications of PSA screening differ by age.

Background

Methods

Results

Conclusions

Publications

Cost implications of PSA screening differ by age.

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