Costs: unit costs, resource use and total costs
| Cost item | Unit cost | Resource use | SE | Total cost | Source |
|---|---|---|---|---|---|
| Cryotherapy surgery | |||||
| Ultrasound | £47.84 | 1 | NA | £47.84 | 18 and 20 |
| Surgeon time (consultant) | £142.00 | 2.5 h | 0.25* | £355.00 | 20 |
| Theatre (including staff, appliances, drugs, etc) | £1125.00 | 2 h | 0.2* | £2250.00 | 20 |
| Additional theatre cost(Argon, Helium, balloon and guidewire) | £260.61 | 1 | NA | £260.61 | 18 |
| Freezing needles (per kit including 2 freezing and 8 temp needles) | £5052.17 | 1 kit | NA | £5052.17 | 18 |
| Overnight stay in hospital | £237.34 | 2 nights | 0.2* | £474.68 | 21 |
| Catheter fitting and removal (40 min in total) | £53.00 | 0.66 h | 0.066* | £35.33 | 20 |
| £8475.64 | |||||
| Cryotherapy medication | |||||
| Antibiotics: ciprofloxacin 10 tablets 250 mg twice daily×3 days | £0.93 | 1 | NA | £0.93 | 18 and 19 |
| Painkillers: acemetacin (Emflex) 60 mg, 90 capsule pack | £28.20 | 1 | NA | £28.20 | 18 and 19 |
| α-blockers: tamsulosin, 400 mg daily 30 tablet pack | £4.42 | 1 | NA | £4.42 | 18 and 19 |
| £33.75 | |||||
| Total cost per cryotherapy patient | £8509.39 | ||||
| Cryotherapy acute adverse events | |||||
| Incontinence: urinary incontinence with intermediate complications | £2170 | 1 | £434 | £2170 | 20 |
| Lower urinary tract symptoms: tamsulosin 30 tablets, 400 µg | £10.47 | 1 | NA | £10.47 | 18 and 19 |
| Perineal pain: ibuprofen 400 mg 30 tabs, 4× daily | £3.61 | 1.42 | NA | £5.13 | 18 and 19 |
| Haematuria: elective inpatient catheter | £2445 | 1 | £489 | £2445 | 20 |
| Urethral stricture: major open urethra procedure | £3836 | 1 | £767 | £3836 | 20 |
| Retention† | £793 | £3963 | 20 | ||
| Fistula‡ | £808 | £4039 | 20 | ||
| First-line ADT regime | |||||
| Bicalutamide (10 days prior to LHRH—first month only) | £5.54 | 1 | NA | £5.54 | 18 and 19 |
| Goserelin: LHRH | £65.00 | 1 | NA | £65.00 | 18 and 19 |
| Bicalutamide (treatment for hot flush side effect) | £5.54 | 0.1 | NA | £0.55 | 18 |
| Delivery of goserelin (practice nurse) | £53.00 | 0.33 h | 0.066* | £17.67 | 18 and 19 |
| Total cost for first-line ADT first cycle | £88.76 | ||||
| Total cost per first-line ADT cycle (every 28 days) | £83.22 | ||||
| Second-line ADT (confirmed metastases) | |||||
| Abiraterone tablets (monthly cost) | £2930.00 | 1 | NA | £2930.00 | 19 |
| Second-line ADT (rising PSA non-metastatic progression) | |||||
| LHRH agonist: leuprorelin acetate | £75.24 | 1 | NA | £75.24 | 18 and 19 |
| Flutamide for proportion who have hot flush side effect | £25.37 | 0.1 | NA | £2.54 | 18 and 19 |
| Delivery (practice nurse) | £53.00 | 0.33 h | 0.066* | £17.67 | 18 and 19 |
| Total cost second-line ADT non-metastatic disease per cycle | £95.44 | ||||
| Mean cost of second-line ADT in progression state per cycle§ | £1229.27 | ||||
Bold typeface indicates total costs for the main cost items.
*γ Distributions used for resource use parameters in the probabilistic analysis.21a
†Depends of proportion-confirmed metastases and non-confirmed. Base-case model 40% metastases (SE 0.08); see table 1.
‡Retention: elective inpatient catheter plus cost of transurethral resection of prostate for 50% of retention patients.
§Fistula: 4 hospital consultations, MRI plus 50% need colostomy or repair surgery.
ADT, androgen deprivation therapy; LHRH, luteinising hormone releasing hormone; PSA, prostate-specific antigen.