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Transition probabilities were derived from the VISION and TheraP trials, and quality-of-life data from the VISION and CARD trials. Costs were derived from statutory health insurance claims data (2019\u20132022). Models simulated a five-year horizon with one-month cycles, applying within-cycle correction and a 3% discount rate. Sensitivity analyses addressed uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For Model I, PRLT plus SoC compared to SoC incurred incremental costs of \u20ac27,200 per patient, with a gain of 0.39 quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) of \u20ac69,418 per QALY gained. In Model II, PRLT plus SoC compared to cabazitaxel achieved incremental savings of \u20ac1,460 per patient and a QALY gain of 0.11, making it the dominant option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Although Germany lacks an explicit willingness-to-pay threshold for interpreting the ICER of Model I, it falls within the range of other reimbursed cancer therapies. This suggests PRLT is cost-effective as second- or third-line treatment for mCRPC. Between 2019 and 2022, hospitals mainly used self-produced\n                      <jats:sup>177<\/jats:sup>\n                      Lu-PSMA-617, which was less costly than the product now commercially available, limiting the generalizability of our findings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07317-9","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T03:28:33Z","timestamp":1746674913000},"page":"4377-4389","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cost-utility analysis of 177Lu-PSMA-617 radioligand therapy in second-line and third-line treatment for metastatic castration-resistant prostate cancer (mCRPC) in Germany"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2550-0306","authenticated-orcid":false,"given":"Carolin","family":"Brinkmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Baum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Stargardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"7317_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.005","author":"J Ferlay","year":"2018","unstructured":"Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. 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ICPO Foundation had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Role of funders"}},{"value":"Not applicable, because all data was taken from published sources and aggregated cost data was used. No individual patient data was collected for the purpose of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate declarations"}},{"value":"Not applicable. All data was taken from published sources and aggregated cost data was used, so no ethics approval was obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"CB and TS have no relevant financial or non-financial interests to disclose. RPB reports: (i) Consultant\u2014Sponsor: Curanosticum Wiesbaden-Frankfurt. Scientific Advisory Board (SAB), Consulting. (ii) Sponsor\u2014ITM, 3B Pharma (3BP), Telix, Sinotau, Jiangsu Huayi Technology (JHT), Full LifeTechnologies, Portland Holding, z Alpha, Novartis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}