Cost-effectiveness of Multiparametric MRI in 800 Men Submitted to Repeat Prostate Biopsy: Results of a Public Health Model

BACKGROUND/AIM: To evaluate the cost-effectiveness of multiparametric magnetic imaging resonance (mpMRI) in men submitted to repeat saturation prostate biopsy (SPBx). MATERIALS AND METHODS: From January 2011 to June 2017, 800 men underwent repeat SPBx; the cost-effectiveness of mpMRI if used as a 'triage test' to avoid unnecessary repeat prostate biopsy was retrospectively calculated using the Italian Public National Health System Day Service. RESULTS: SPBx vs. MRI fusion targeted biopsy diagnosed 215 (89.5%) vs. 184 (76.6%) out of 240, respectively. The overall cost of the 800 prostate biopsies was 138,221 €; the use of mpMRI as triage test would have spared 364/800 procedures, equivalent to 60,905 € (44% of the entire cost), whilst missing 15/205 (7.3%) cases of clinically significant cancer. CONCLUSION: mpMRI used as a triage test could reduce the need for prostate biopsies by about 45%, thereby improving cost-effectiveness, however, patients should be informed of the false-negative rate associated with mpMRI.