Table 3 Subgroup cost-effectiveness results.

From: The ProtecT randomised trial cost-effectiveness analysis comparing active monitoring, surgery, or radiotherapy for prostate cancer

Allocation arm

na

Adjusted costs (£) Mean (95% CI)

Adjusted QALYs Mean (95% CI)

Comparison

Incremental cost (£) (95% CI)b

Incremental QALY (95% CI)b

ICERc (£/QALY)

Incremental NMB (£) at £20,000/ QALY (95% CI)

Age group 1: Younger—under 65 years old at randomisationd

 Active monitoring (AM)

229

6030 (5534−6526)

7.175 (6.945−7.404)

     

 Radical prostatectomy (RP)

232

7458 (6966−7950)

6.933 (6.706−7.160)

RP vs. AM

1428 (759−2114)

−0.241 (−0.571 to 0.085)

AM dominatese RP

−6257 (−12,763 to 250)

 Radiotherapy (RT)

223

7585 (7083−8087)

7.095 (6.863−7.327)

RT vs. AM

1555 (841−2345)

−0.079 (−0.417 to 0.241)

AM dominates RT

−3142 (−9719 to 3435)

Age group 2: Older—65 years old and over at randomisationd

 Active monitoring (AM)

141

5671 (4927−6415)

6.654 (6.376−6.933)

     

 Radiotherapy (RT)

141

7047 (6304−7789)

7.104 (6.825−7.382)

RT vs. AM

1376 (134−2312)

0.449 (0.045−0.875)

3061

7612 (−337 to 15,561)

 Radical prostatectomy (RP)

135

7637 (6874−8400)

6.853 (6.568−7.138)

RP vs. RT

590 (−349 to 1754)

−0.250 (−0.621 to 0.144)

RT dominates RP

−5599 (−13,665 to 2467)

D’Amico group 1: Lowf

 Active monitoring (AM)

217

4833 (4359−5308)

7.060 (6.830−7.290)

     

 Radical prostatectomy (RP)

226

6806 (6344−7268)

6.843 (6.619−7.067)

RP vs. AM

1973 (1272−2620)

−0.217 (−0.551 to 0.103)

AM dominates RP

−6314 (−12,772 to 144)

 Radiotherapy (RT)

228

7050 (6585−7514)

7.017 (6.792−7.242)

RT vs. AM

2216 (1512−2931)

−0.043 (−0.381 to 0.267)

AM dominates RT

−3078 (−9566 to 3410)

D’Amico group 2: Intermediate/highf,g

 Active monitoring (AM)

120

7453 (6548−8358)

6.494 (6.194−6.794)

     

 Radiotherapy (RT)

110

7852 (6909−8795)

6.874 (6.561−7.188)

RT vs. AM

399 (−1086 to 1560)

0.380 (−0.049 to 0.849)

1049

7209 (−1604 to 16,023)

 Radical prostatectomy (RP)

108

8807 (7852−9762)

6.668 (6.352−6.985)

RP vs. RT

955 (−267 to 2246)

−0.206 (−0.635 to 0.228)

RT dominates RP

−5079 (−14,131 to 3972)

Grade group 1h

 Active monitoring (AM)

275

5287 (4867−5708)

7.132 (6.924−7.340)

     

 Radical prostatectomy (RP)

275

6892 (6472−7312)

6.997 (6.790−7.205)

RP vs. AM

1605 (999−2223)

−0.135 (−0.453 to 0.163)

AM dominates RP

−4302 (−10,233 to 1629)

 Radiotherapy (RT)

279

7029 (6612−7446)

7.144 (6.938−7.350)

RT vs. AM

1742 (1143−2388)

0.012 (−0.288 to 0.303)

146,076

−1503 (−7413 to 4407)

Grade group 2 and higherh,i

 Active monitoring (AM)

95

7799 (6694−8904)

6.558 (6.223−6.892)

     

 Radiotherapy (RT)

85

8522 (7359−9685)

6.943 (6.591−7.295)

RT vs. AM

723 (−1160 to 2337)

0.385 (−0.108 to 0.905)

1878

6974 (−2819 to 16,767)

 Radical prostatectomy (RP)

92

9249 (8130−10,369)

6.598 (6.259−6.937)

RP vs. RT

727 (−856 to 2188)

−0.345 (−0.797 to 0.132)

RT dominates RP

−7,625 (−17,445 to 2194)

  1. aIncluding only participants for whom we have complete cost and QALY information.
  2. bBias-corrected and accelerated confidence interval based on 5000 bootstrap replications.
  3. cICERs cannot be estimated directly from the incremental costs and QALYs due to rounding.
  4. dAdjusted for study centre, Gleason score (2–6, 7, 8–10) and PSA at baseline. QALYs were also adjusted for baseline utility.
  5. eDominates means that the treatment is less costly and more effective than the other treatment.
  6. fAdjusted for study centre and age at baseline. QALYs were also adjusted for baseline utility.
  7. g D’Amico group 2, 0.02% of bootstrap replicates failed to converge.
  8. hAdjusted for study centre, age at baseline, and PSA at baseline. QALYs were also adjusted for baseline utility.
  9. iGrade group 2 and higher, 0.7% of bootstrap replicates failed to converge.
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