The EARLY study: Economic evAluation of a novel pRostate cancer gLYcan-based diagnostic tool

Health Research BC is providing match funds for this research project, which is funded by the GlycoNet’s Collaborative Team Grant – Cycle II.

Early detection of prostate cancer uses methods that are controversial and lead to uncertainty in care; this leads to a lot of overdiagnosis and overtreatment in men who are healthy or have inactive disease. We recently developed a test using a sugar found on aggressive cancer cells that acts as a biomarker to detect high-risk cancer in patients and support biopsy decision-making. But, for this test to be taken up in Canada to improve patient care, it needs to be evaluated for its potential value for money for the healthcare payer. This pan-Canadian project is the first analysis of the cost-effectiveness of a new sugar-based prostate cancer diagnostic tool. It will tell us whether the maximum possible gains from the new test versus status quo (or other new technologies) are worth their costs, and in which subgroups of patients we see the most positive net benefit.

The leading PI is Dr. Conklin, assistant professor at UBC’s Faculty of Pharmaceutical Sciences and scientist at UBC’s Centre for Health Evaluation and Outcome Sciences (CHEOS). Dr. Conklin’s BC-based team include Drs. Wei Zhang and Larry Lynd (also Scientists at CHEOS) and Dr. Williams (inventor of the new sugar-based test); the team also includes Dr. Liu, a clinician collaborator from Sunnybrook Hospital in Toronto.

This economic evaluation project will address a critical gap in test development early on to avoid the pitfall of creating an economically non-feasible test. The output of this project could contribute to improved patient care and to better decision-making of patients, guideline developers and health ministers.

Please visit GlycoNet to learn more about this project.

End of Award Report – June 2023

Results

In this decision analytical model framework, using real-world whole-population data, a novel rapid assessment and treatment (RAT) (based on an existing new biomarker’s characteristics) was dominant compared to the standard of care. A range of scenarios demonstrates how results were sensitive to the cost and accuracy of the RAT, prostate cancer (PCa) prevalence, the proportion of high-grade PCa, and assumptions about undetected cases. This cost-effectiveness study showed that a new and more accurate biomarker or other RATs to inform biopsy decisions can be a cost-saving or cost-effective strategy, thereby improving PCa diagnosis and treatment.

Potential Influence

This research may inform decision-makers in BC about the total costs associated with prostate cancer, which we have published. It will also help guide future decision-making on newer biomarkers as we did a cost-effectiveness analysis to show the threshold for acceptable costs of newer technologies to guide biopsy decisions.

Next Steps

Our next steps are to complete the publication process of our second main results paper (just submitted to Cancer Medicine) and to brainstorm with our collaborator about one more paper/study using the same data that our team has now analysed.