Cost-Effectiveness of Prophylactic Cranial Irradiation vs MRI Surveillance for Small Cell Lung Cancer
This study evaluated the cost-effectiveness of prophylactic cranial irradiation compared with magnetic resonance imaging (MRI) surveillance in this patient population. Cost-effectiveness of the treatment approaches were based on currently available evidence and in the context of the proposed Centers for Medicare & Medicaid Services alternative payment model. A Markov state transition model was developed to compare MRI surveillance alone vs prophylactic cranial irradiation for extensive-stage SCLC. Medicare reimbursement data from 2019 was used to dictate cost estimates. The incremental cost-effectiveness ratio (ICER) was used to compare strategies with effectiveness in quality-adjusted life years (QALYs). The willingness-to-pay threshold was $100,000 per QALY gained.