Direct Cost for Initial Management of Prostate Cancer: A Systematic Review

Abstract

Background: Prostate cancer (pca) is the most common non-skin cancer among men in Canada and other Western countries. Increased prevalence and higher cost of newer treatments have led to a significant rise in the economic burden of pca. The objectives of the present study were to systematically review the literature on direct costs for the initial management of pca, and to examine the methodologic considerations across studies. Methods: Bibliographic databases were systematically searched for peer-reviewed articles in English. Studies were reviewed for methodologic considerations and mean direct cost of active surveillance or watchful waiting (as/ww) and initial treatments. Direct cost was standardized to 2011 Canadian dollars. Results: After a review of abstracts and full-text papers, seventeen articles met the eligibility criteria and were included in the review. Studies were published during 1992–2010. The studies reported on health care systems in the United States, France, the United Kingdom, German, Italy, and Spain. Our review identified a lack of methodologic consensus, leading to variation in direct costs between studies. Nevertheless, results indicate a significant direct cost of pca treatments. Conclusions: The existing literature lacks methodologically rigorous studies on the direct costs of pca treatments specific to publicly funded health care systems. Additional studies are required to appreciate the direct costs of newer treatments and the impact of their adoption on the growing economic burden of pca management.

What does it cost Medicare to diagnose and treat men with localized prostate cancer in the first year?

“…Most of the studies produced a mean cost for their study sample and estimated an average cost ranging from US$13,000 3 to US$18,000 2,4,7 for the initial care for prostate cancer. Also consistent with other studies, the results of our analysis showed that the Medicare costs varied with the choice of initial treatment . The costs attributable to prostate cancer were lower for patients who received watchful waiting and higher for patients who underwent ADT or radical prostatectomy …”

Costs in different states of prostate cancer

“…in our study, the analysis captured health care resource utilisation and direct costs both in the primary and specialist care settings, assessed productivity costs due to disease and also informal care given by family members or relatives and friends. Many studies in this area have focused on direct health care costs only [13], although there have been some attempts to assess productivity costs also in the cancer setting [5,[14][15][16].…”

Medical resource utilization of abiraterone acetate plus prednisone added to androgen deprivation therapy in metastatic castration‐naive prostate cancer: Results from LATITUDE

“…As a result, it imposes a substantial burden of illness, which is expected to increase with an aging population and a rising frequency of diagnosis . Once prostate cancer has metastasized, the disease is especially deadly and costly …”

“…2 Once prostate cancer has metastasized, the disease is especially deadly and costly. 3 The management of metastatic prostate cancer is categorized by 2 phases: while the disease is initially sensitive to androgen deprivation therapy (ADT; ie, castration-sensitive or castration-naive) and after it becomes resistant to ADT (ie, castration-resistant). 4 For metastatic hormone-sensitive prostate cancer, the current treatment landscape is changing, although ADT remains a cornerstone therapy.…”

“…The management of prostate cancer is resource-intensive and places a significant economic burden on the health care system. 3 As an add-on therapy to ADT, AA+P may result in additional side effects, and the full extent of this burden versus the potential offsets from improved clinical outcomes needs to be understood. In addition to the clinical and patient-reported outcomes, medical resource utilization (MRU) data were collected in the LATITUDE trial.…”