Poster Presentation 2025 National Cancer Survivorship Conference

Cost-utility analysis of a treatment decision aid (Navigate) for men living with prostate cancer (#138)

Dan Lindsay 1 2 , Penny Schofield 3 4 5 , Matthew J Roberts 6 7 8 , John Yaxley 6 7 9 , Steve Quinn 3 , Natalie Richards 3 , Mark Frydenberg 10 11 , Robert ('Frank') Gardiner 6 7 , Nathan Lawrentschuk 5 12 13 , Ilona Juraskova 14 , Declan G Murphy 4 5 , Louisa G Collins 1 7 15 16
  1. QIMR Berghofer, Brisbane, QUEENSLAND, Australia
  2. School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
  3. Swinburne University of Technology, Melbourne, Victoria, Australia
  4. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. The University of Melbourne, Melbourne, Victoria, Australia
  6. Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
  7. The University of Queensland, Brisbane, Queensland, Australia
  8. Redcliffe Hospital, Redcliffe, Queensland, Australia
  9. Wesley Hospital, Brisbane, Queensland, Australia
  10. Cabrini Institute, Melbourne, Victoria, Australia
  11. Monash University, Melbourne, Victoria, Australia
  12. Epworth Health Centre, Melbourne, Victoria, Australia
  13. Royal Melbourne Hospital, Melbourne, Victoria, Australia
  14. The University of Sydney, Sydney
  15. Queensland University of Technology, Brisbane
  16. Cancer Council Queensland, Brisbane, Queensland, Australia

Background: Prostate cancer is the most commonly diagnosed cancer in men across the world. Low-risk prostate cancers can be managed with active treatments or active surveillance, which takes a watch and wait approach that may produce anxiety amongst men living with prostate cancer and their families. The Navigate online decision aid provides men living with prostate cancer textual, graphical, and audio-visual content tailored to the local healthcare context to describe and compare different management options. Current evidence for the cost-effectiveness of decision aids to guide management decisions for men living with prostate cancer is limited.

Method: We examined the cost-utility of Navigate for men living with prostate cancer compared with usual care (no decision aid). A Markvov model was constructed with a government healthcare perspective and 10-year time horizon. Navigate trial data (n = 302) and relevant published literature were used for model inputs. Incremental costs and quality-adjusted life-years (QALYs) were calculated for the two strategies. One-way and probabilistic sensitivity analyses were undertaken to address model uncertainty.

Results: On average, the Navigate strategy was estimated to cost AU$8,899 (95% Uncertainty Interval (UI): $7,509, $10,438) and produce 7.08 (95% UI: 6.73, 7.36) QALYs compared with AU$9,559 (95% UI: $8,177, $11,017) and 7.03 (95% UI: 6.67, 7.31) QALYs for usual care. The Navigate strategy dominated usual care as it produced cost-savings and higher QALYs, albeit small differences in both outcomes over 10 years. The likelihood of Navigate being cost-effective at a conventionally acceptable threshold of AU$50,000 per QALY gained was 99.7%, driven by the higher acceptance and uptake of active surveillance.

Conclusions: Using an online decision aid for men living with prostate cancer appears to be cost-effective relative to usual care in Australia. Wider implementation of decision aids may better educate men living with prostate cancer and their families about their management options.