Temporal trends of prostate cancer diagnostics in Australia: Has the introduction of a magnetic resonance imaging prostate subsidy fulfilled its cost-saving promises?

This study aims to assess whether MRIp had a statistically significant effect on prostate biopsies in Australia and decreased biopsies performed in Australia. Temporal trends and cost effectiveness of this policy was also analysed. National and state-level data was obtained from the Australian Medicare Benefits Schedule from 1 January 2006 to 1 January 2024 on MRIp and prostate biopsies. A regression model was used to calculate the impact of MRIp use on the number of biopsies. Paired t-test was used to determine statistical significance between population-adjusted pre- and post-subsidy rates. Cost-effectiveness of the subsidy was calculated. MRIp had a statistically significant impact on biopsies, with an OR of 1.42 MRIps to biopsies (95% CI 1.358, 1.473; p < 0.0002) at a national level. State-level data suggested it impacted most but not all states. Population-adjusted prostate biopsy rates decreased from 215 per 100,000 men per year to 182 per 100,000 men following the introduction of MRIp subsidy (p = 0.02). Cost analysis suggests that MRIp subsidy has led to approximately $10 million in cost savings since 2018, and projected savings during policy proposal were vastly over-estimated. Government subsidised MRIp in Australia has a statistically significant effect on prostate biopsies. There has been a reduction in prostate biopsies, but it is likely more reflective of the rapid development and complexity within prostate cancer diagnostics. Subsidy of MRI is questionable in its cost effectiveness.