1) Unnecessary Biopsies: $1.44 Billion
Currently, the yield of prostate cancer with blind biopsies is 12% per NCI study. In practical terms, if we had 240,000 new cases diagnosed in 2006 (mostly due to abnormal PSA), it means that about 2 Million biopsies were performed. The costs of all biopsies would be $4 Billion.

Assumption #1: Imaging procedures will increase cancer yield to even as low yield as 25%. Then we would have decreased the number of biopsies to 960,000 per year, with the related costs of $1,920,000. Thus, the cost savings would be $2.08 Billion.

Assumption #2: Every man with abnormal PSA (2 million, as above) will have imaging screening procedure, with estimated cost of at least $200 per optical and/or ultrasound imaging. The additional cost to health care will be 400 Million.

Assumption #3: Each man diagnosed with prostate cancer on biopsy will have diagnostic MRI (for staging and aggressiveness assessment), with est. cost of $1000 per procedure. The additional cost to health care will be $240 Million.

Net Estimated Saving to Health Care: $2.08 Billion ($400 Million for imaging screening plus $240 Million for imaging diagnostics) = $1.44 Billion

2) Unnecessary Treatment: $1.6 Billion
Assumption #1: Conservatively estimated, 25% of men with prostate cancer currently undergoing radical surgery or radiation would benefit from active surveillance, and the unnecessary treatment results in health care costs of $2 Billion (25% of the annual costs of $8 Billion).

Assumption #2: The cost of treatment is at least $20,000. Current available data: The costs of radical surgery is about $20,000-$30,000 national average; and the cost of standard radiation treatment is $20,000, while the cost of IMRT is about $40,000 – 50,000.

Assumption #3: Each man who will undergo active surveillance instead of treatment will have MRI procedure per year for 4 years (in addition to the original diagnostic procedure counted above). At $1000 per procedure, this will bring the additional cost of MRI to $4,000 per patient, or 20% of the lowest costs of treatment, or $400 Million (compared to est. $2 Billion, as above).

Net Estimated Cost Savings: $2 Billion - 400 Million = $1.6 Billion

3) Transition from Current Methods of Treatment to Minimally-Invasive Procedures: $2 Billion
Assumption #1: The cost of minimally-invasive procedures is 50% of the current treatment (the worst case scenario). Per published data, the cost of minimally-invasive procedures is estimated at about 25% to 50% of standard radiation and radical surgery.

Assumption #2: With earlier diagnosis and improved localization with imaging, we will replace at least 50% of current standard treatment with minimally-invasive procedures.

Net Estimated Cost Savings: $2 Billion (compared to the current $8 Billion per year)

4) Total Estimated Annual Savings to Health Care: $5.04 Billion per year