[AVBC 2025] Cost-effectiveness analysis of a biopsy-free diagnostic strategy for prostate cancer
Care Process & Redesign
Appropriate & Value-based Care Conference
National University Health System
SingHealth
5 December 2025
The study aimed to evaluate the cost-effectiveness of a combined PSMA PET/CT and mpMRI, biopsy-free diagnostic approach for. In men with raised PSA, a combined imaging strategy was cost-effective in comparison to the current practice of mpMRI followed by a.
Year Submitted: 2025
Published Date: 05 December 2025
Tags: Cost Effectiveness, Cost Saving, Productivity, Quality Improvement, Clinical Practice Improvement, Workflow Redesign, Care Process ＆ Redesign
About this Content
Aims
The study aimed to evaluate the cost-effectiveness of a combined PSMA PET/CT and mpMRI, biopsy-free diagnostic approach for clinically significant prostate cancer.
Background
PSMA PET/CT has demonstrated superior sensitivity and specificity in prostate cancer detection compared to traditional imaging modalities. A biopsy-free diagnostic pathway could reduce procedural risks, patient discomfort, and resource utilization.
Methods
A decision tree model was designed to compare the two strategies. Each strategy was evaluated on costs and Quality-Adjusted Life-Years (QALYs). One-way sensitivity analysis and probabilistic sensitivity analyses were performed.
Results
Combined PSMA PET/CT and mpMRI is a cost-effective diagnostic strategy for clinically significant prostate cancer. The cohort prevalence of true positive cancer influenced the ICER. In more carefully selected cohorts, such as with a higher PSA or MRI threshold, the imaging strategy was even more cost-effective.
Conclusion
In men with raised PSA, a combined imaging strategy was cost-effective in comparison to the current practice of mpMRI followed by a prostate biopsy. There is potential for reducing the need for invasive diagnostic procedures for prostate cancer.
Lessons Learnt
Combined PSMA PET/CT and mpMRI is a cost-effective diagnostic strategy for clinically significant prostate cancer. The cohort prevalence of true positive cancer influenced the ICER. In more carefully selected cohorts, such as with a higher PSA or MRI threshold, the imaging strategy was even more cost-effective.
Keywords
PSMA PET/CT, mpMRI, prostate cancer, cost-effectiveness, diagnostic strategy
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth, National University Health System |
Organization(s) Involved | Singapore General Hospital, National University Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Oncology |
Project Lead(s) | Joshua Tung Yi Min |
Project Member(s) | Edmund Teo Pek Siang |
Connect with this contributor!
Joshua Tung Yi Min - joshua.tung@mohh.com.sg