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Carl B

Carl Borrebaeck


Carl B

The Value of a New Diagnostic Test for Prostate Cancer : A Cost-Utility Analysis in Early Stage of Development


  • Adam Fridhammar
  • Ulrika Axelsson
  • Ulf Persson
  • Anders Bjartell
  • Carl A.K. Borrebaeck

Summary, in English

Background: Standard biopsy for prostate cancer diagnosis is an unpleasant and sometimes painful procedure with a detection rate as low as around 50%. Consequently, an accurate blood-based test would be highly desirable to improve the predictive accuracy. However, the clinical value of a new blood test for diagnosing prostate cancer depends on its sensitivity and specificity, in relation to the selected target population. Objective: The aim of this analysis was to investigate the health-economic value of introducing a new and more accurate diagnostic blood-based test to identify men in need of a biopsy to diagnose prostate cancer. Method: We developed a Discrete Event Simulation Model with outputs including number of biopsies, cancer diagnosis, treatments and prostate cancer deaths. The analysis was performed from a health care perspective. It used epidemiologic data, treatment patterns, and health care costs from the Swedish region Skåne (population of 1.3 million). A 90% sensitivity and specificity of the new test was assumed. Results: Among 31,250 men, age 50–69 years, 16.4% had a PSA between 3.0 and 9.9 µg/L and 28.9% a PSA of 2.0–9.9 µg/L. Testing men with PSA 3.0–9.9 µg/L, as in current clinical practice, decreased the number of biopsies by 3595, detected 61 more cancers, resulting in and two more fatalities and subsequently a loss of 14 QALYs. Cost offsets could justify a test value of SEK 4996. Testing a larger population, PSA 2.0–9.9 µg/L prevented 6 deaths, added 50 QALYs, and could justify a value of the test of SEK 5165, given a value of health of SEK 500,000 per QALY. Conclusion: A new blood-based test for prostate cancer has a significant potential to reduce the number of biopsies needed, resulting in reduced health care costs and improve patient care.


  • Department of Immunotechnology
  • LUCC: Lund University Cancer Centre
  • Urological cancer, Malmö
  • EpiHealth: Epidemiology for Health
  • Create Health

Publishing year







PharmacoEconomics - Open





Document type

Journal article




  • Urology and Nephrology



Research group

  • Urological cancer, Malmö


  • ISSN: 2509-4262