Budget impact analysis
SECONDARY, PROSTATE CANCER
We conducted a budget impact analysis at a population level to compare the average secondary care costs associated with all men in the two arms of CAP (i.e. an intention-to-treat analysis on all men in the trial, whether or not diagnosed with prostate cancer) to give an estimate of the likely budgetary impact to hospitals of introducing a single PSA-based screening programme in the UK over a time horizon of five years. The budget impact analysis adhered to relevant guidelines developed by the International Society for PharmacoEconomics and Outcomes Research (ISPOR) [A simple cost calculator approach was taken, based on the observed intention-to-treat differences in costs between the two trial arms. The two groups were compared as randomised on an intention-to-treat basis using a multi-level modelling approach, incorporating both cluster and practice levels. As the budget impact analysis aims to estimate the actual impact at each time point rather than the perceived value placed on the investment, costs were not discounted, in line with good practice principles [Cost differences between the arms were extrapolated to the population eligible for screening based on population estimates from the Office of National Statistics for England and Wales [