Cost-Effectiveness of the Use of Gold Anchor™ Markers in Prostate Cancer

Introduction A common treatment for prostate cancer is external beam radiation therapy. A way to target the radiation is to use implantable gold fiducial markers (GFMs). The GFMs serve as reference points enabling tumor localization during treatment. Today, there are several GFMs available on the market but no clinical guidelines as to which one to use. The aim of this study was to estimate the cost-effectiveness of Gold Anchor GFMs (Naslund Medical AB, Huddinge, Sweden) implanted with a 22G needle, compared to other GFMs implanted with a 17-18G needle, in the prostate gland of patients with prostate cancer. Methods Costs, life years, and quality-adjusted life years (QALYs) were estimated over a lifelong time horizon for each treatment strategy using a decision-analytic model. Data used in the model were obtained from published literature or were estimated by an expert elicitation technique. The primary outcome measure was an incremental cost-effectiveness ratio (ICER). Results Gold Anchor GFM was found to be a dominant alternative with both lower costs [-8.7 US Dollars (USD)] and a gain in QALYs (0.015) when compared with other GFMs. The lower cost was achieved by fewer visits for imaging in treatment planning, and by reduced risk of infections and sepsis. The QALY gain was driven by a reduced risk of sepsis. Conclusion The use of Gold Anchor GFMs as reference points to target radiation is a cost-effective alternative when compared to other GFMs. However, this analysis is based on expert elicitation regarding some crucial parameters, and further clinical studies of the use of GFMs are needed.