Costs and Complications After a Diagnosis of Prostate Cancer Treated With Time-Efficient Modalities: An Analysis of National Medicare Data

Tang, Chad; Lei, Xiudong; Smith, Grace L.; Pan, Hubert Y.; Hess, Kenneth R.; Chen, Aileen B.; Hoffman, Karen E.; Chapin, Brian F.; Kuban, Deborah A.; Anscher, Mitchell S.; Shih, Ya Chen Tina; Frank, Steven J.; Smith, Benjamin D.

doi:10.1016/j.prro.2020.02.014

Cited by 6 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the model was not sensitive to fluctuations in costs associated with complications from PRT. Although the study by Pan et al 21 provides the most granular data on intensity-modulated radiotherapy complications, a recent study 35 of complications associated with other radiation modalities used for prostate cancer using Medicare fees found similar costs. Furthermore, costs will invariably vary across different health care systems.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Prostate Radiation Therapy for Men With Newly Diagnosed Low-Burden Metastatic Prostate Cancer

Lester-Coll

Ades

et al. 2021

JAMA Netw Open

View full text Add to dashboard Cite

IMPORTANCEProstate radiation therapy (PRT) is a treatment option in men with low-volume metastatic prostate cancer based on the results of the Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy Arm H (STAMPEDE-H) trial. However, the costeffectiveness of this treatment remains unaddressed. OBJECTIVE To assess the cost-effectiveness of PRT when added to androgen deprivation therapy (ADT) for men with low-volume metastatic hormone-sensitive prostate cancer (mHSPC). DESIGN, SETTING, AND PARTICIPANTS This economic evaluation used microsimulation modeling to evaluate the cost-effectiveness of adding PRT to ADT. A simulated cohort of 10 000 individuals with low-volume mHSPC was created. Data from men with low-volume mHSPC were extracted and analyzed from January 18, 2019, through July 4, 2020. Transition probabilities were extracted from the STAMPEDE-H study. Health states included stable disease, progression, second progression, and death. Individual grade 2 or higher genitourinary and gastrointestinal toxic events associated with PRT were tracked. Univariable deterministic and probabilistic sensitivity analyses explored uncertainty with regard to the model assumptions. Health state utility estimates were based on the published literature. EXPOSURES The combination of PRT and ADT using regimens of 20 fractions and 6 weekly fractions. MAIN OUTCOMES AND MEASURESOutcomes included net quality-adjusted life-years (QALYs), costs in US dollars, and incremental cost-effectiveness ratios. A strategy was classified as dominant if it was associated with higher QALYs at lower costs than the alternative and dominated if it was associated with fewer QALYs at higher costs than the alternative. RESULTSFor the base case scenario of men 68 years of age with low-volume mHSPC, the modeled outcomes were similar to the target clinical data for overall survival, failure-free survival, and rates of PRT-related toxic effects. The addition of PRT was a dominant strategy compared with ADT alone, with a gain of 0.16 QALYs (95% CI, 0.

show abstract

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Prostate Radiation Therapy for Men With Newly Diagnosed Low-Burden Metastatic Prostate Cancer

Lester-Coll

Ades

et al. 2021

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…In recent years, there have been increasing needs and trends to use large administrative health data sets to construct a cohort of people with a specific health condition and follow them longitudinally to capture real-world health care utilization and costs. For PCa, recent costing studies based on such data and design have measured and compared the costs by factors such as age, disease state or stage, tumor grade, treatment strategy, and/or care phase (including the diagnosis phase before diagnosis) [ 21 , 22 , 23 , 24 , 25 ]. However, previous data were either relatively outdated and thus not well representative of the most recent PCa treatment guidelines or only measured costs by some factors instead of all.…”

Section: Introductionmentioning

confidence: 99%

Health Care Costs Attributable to Prostate Cancer in British Columbia, Canada: A Population-Based Cohort Study

et al. 2023

View full text Add to dashboard Cite

We aimed to estimate the total health care costs attributable to prostate cancer (PCa) during care phases by age, cancer stage, tumor grade, and primary treatment in the first year in British Columbia (BC), Canada. Using linked administrative health data, we followed a cohort of men aged ≥ 50 years at diagnosis with PCa between 2010 and 2017 (Cohort 1) from the diagnosis date until the date of death, the last date of observation, or 31 December 2019. Patients who died from PCa after 1 January 2010, were selected for Cohort 2. PCa attributable costs were estimated by comparing costs in patients to matched controls. Cohort 1 (n = 22,672) had a mean age of 69.9 years (SD = 8.9) and a median follow-up time of 5.2 years. Cohort 2 included 6942 patients. Mean PCa attributable costs were the highest during the first year after diagnosis ($14,307.9 [95% CI: $13,970.0, $14,645.8]) and the year before death ($9959.7 [$8738.8, $11,181.0]). Primary treatment with radiation therapy had significantly higher costs each year after diagnosis than a radical prostatectomy or other surgeries in advanced-stage PCa. Androgen deprivation therapy (and/or chemotherapy) had the highest cost for high-grade and early-stage cancer during the three years after diagnosis. No treatment group had the lowest cost. Updated cost estimates could inform economic evaluations and decision-making.

show abstract

“…Promotion of AS is an important strategy to reduce the treatment costs for low‐risk PCa. To date, several studies have compared AS with other treatments using a mathematical model 5–10 or electronic health records (EHR) such as Medicare 11–13 . However, no study has analyzed the outcomes using actual treatment trends in Japan.…”

Section: Introductionmentioning

confidence: 99%

“…To date, several studies have compared AS with other treatments using a mathematical model [5][6][7][8][9][10] or electronic health records (EHR) such as Medicare. [11][12][13] However, no study has analyzed the outcomes using actual treatment trends in Japan. Thus, this study aimed to evaluate the costeffectiveness of AS compared with that of robot-assisted laparoscopic prostatectomy (RALP), intensity-modulated radiation therapy (IMRT), brachytherapy (BT), and HT for men diagnosed with low-risk localized PCa in Japan.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the medical costs between active surveillance and other treatments for early prostate cancer in Japan using data from the PRIAS‐JAPAN study

et al. 2022

View full text Add to dashboard Cite

Abbreviations & Acronyms AS = active surveillance BT = brachytherapy DPC = diagnosis procedure combination EBRT = external beam radiation therapy EHR = electronic health records GS = Gleason score HT = hormone therapy IMRT = intensity-modulated radiation therapy JPY = Japanese yen LH-RH = luteinizing hormonereleasing hormone MRI = magnetic resonance imaging PCa = prostate cancer PSA = prostate-specific antigen QALYs = quality adjusted life years QOL = quality of life RALP = robot-assisted laparoscopic prostatectomy USD = United States dollar

show abstract

Costs and Complications After a Diagnosis of Prostate Cancer Treated With Time-Efficient Modalities: An Analysis of National Medicare Data

Cited by 6 publications

References 22 publications

Cost-effectiveness of Prostate Radiation Therapy for Men With Newly Diagnosed Low-Burden Metastatic Prostate Cancer

Cost-effectiveness of Prostate Radiation Therapy for Men With Newly Diagnosed Low-Burden Metastatic Prostate Cancer

Health Care Costs Attributable to Prostate Cancer in British Columbia, Canada: A Population-Based Cohort Study

Comparison of the medical costs between active surveillance and other treatments for early prostate cancer in Japan using data from the PRIAS‐JAPAN study

Contact Info

Product

Resources

About