Supportive Care in Cancer

, Volume 24, Issue 2, pp 879–886 | Cite as

Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis

  • Alison M. PearceEmail author
  • Fay Ryan
  • Frances J. Drummond
  • Audrey Alforque Thomas
  • Aileen Timmons
  • Linda Sharp
Original Article



Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland—the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice.


A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer’s perspective over a 10-year time horizon.


Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted.


This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.


Prostate cancer Follow-up Cancer survivorship Clinical practice guidelines Cost minimisation Economic model 



We are grateful to the following: The Follow-Up After Cancer Treatment (FACT) Advisory Group (Donal Buggy, Phyllis Butow, Pamela Gallagher, Paul Hanly, David Galvin, Racheal Gooberman-Hill, Louise Mullan, Micheal O Ríordáin, Eila Watson, Verity Watson) for guidance on the research programme; Pamela Gallagher, Michal Molcho, and Ciaran O’Neill for participation in the ICE Steering Committee and comments on a draft of the paper; Marita Hennessy for access to the PICTURE2 data and comments on a draft of the paper; and Sophie Whyte for supervision and support of the student project that formed the basis of this paper.

Conflict of interest

No authors have any conflict of interest to declare.

Financial and other support

This work was funded by a Health Research Board (HRB) Interdisciplinary Capacity Enhancement (ICE) Award, which funds post-doctoral fellowships for Alison Pearce, Audrey Alforque Thomas and Aileen Timmons (ICE/2012/9). The surveys of prostate cancer survivors from which the EQ-5D-5L data was derived were funded by the Irish Cancer Society (PiCTure 2 study) and the Health Research Board (HRA_HSR/2010/17), Prostate Cancer UK (NI09-03 and NI-PG13-001) and Northern Ireland R&D (PiCTure study).


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Alison M. Pearce
    • 1
    Email author
  • Fay Ryan
    • 2
  • Frances J. Drummond
    • 1
  • Audrey Alforque Thomas
    • 3
  • Aileen Timmons
    • 1
  • Linda Sharp
    • 1
  1. 1.National Cancer Registry IrelandCorkIreland
  2. 2.University of SheffieldSheffieldUK
  3. 3.National University IrelandGalwayIreland

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