Long-term health care costs for patients with prostate cancer: a population-wide longitudinal study in New South Wales, Australia

Cronin, Paula; Kirkbride, Brent; Bang, Albert; Parkinson, Bonny; Smith, David P.; Haywood, Philip

doi:10.1111/ajco.12582

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…Brachytherapy was reported to be similar to, but less expensive than, intensity-modulated radiation therapy and radical prostatectomy with regard to quality-adjusted life expectancy and average lifetime cost. 10,11 Many new treatment modalities have been developed for localised prostate cancer. However, the number of patients undergoing brachytherapy is expected to increase because of the high biochemical recurrence-free rates, low toxicity, lower cost efficiency, and the increasing number of prostate cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of tadalafil against lower urinary tract symptoms after low-dose-rate brachytherapy in prostate cancer patients

Saito

Minagawa

Ogawa

et al. 2018

Journal of Clinical Urology

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This study was performed to evaluate the effects of addition of tadalafil to tamsulosin in the treatment of brachytherapy patients with lower urinary tract symptoms (LUTS). Methods: Localized prostate cancer patients who developed LUTS after low-dose-rate brachytherapy (LDR-BT) were first treated with alpha-1 blockers (tamsulosin, 0.2 mg per day). Those still suffering from LUTS were additionally treated with phosphodiesterase type 5 inhibitor (tadalafil, 5 mg/day). LUTS was evaluated by the International Prostate Symptom Score (IPSS), IPSS Quality of Life (QOL) score, Overactive Bladder Symptom Score (OABSS), and the International Index of Erectile Function 5 (IIEF5) score before brachytherapy, before treatment with tadalafil, and after three months of treatment with tadalafil. Results: Twenty-three patients were enrolled in the study. Each subscore of the IPSS (storage symptom, voiding symptom, and postvoiding symptom) and the QOL score improved, but OABSS and IIEF5 did not show significant recovery after addition of tadalafil treatment. When patient characteristics and each question score were surveyed, time from seed implantation until treatment with tadalafil showed the strongest correlation with recovery. Conclusions: Addition of tadalafil to tamsulosin treatment was effective against LUTS in localised prostate cancer patients after brachytherapy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of tadalafil against lower urinary tract symptoms after low-dose-rate brachytherapy in prostate cancer patients

Saito

Minagawa

Ogawa

et al. 2018

Journal of Clinical Urology

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“…AE costs associated with hospitalisation, such as rectal bleeding and grade ≥ 3 docetaxel AEs (neutropenia, anaemia, infection, nausea, diarrhoea and vomiting), were calculated based on the Australian Public Hospitals Cost Report [ 35 ]. Costs in the disease progression phase were based on Cronin et al, which estimated the annual healthcare ongoing costs up to 9.5 years for several treatment pathways in using Australian administrative data ( N = 1873) [ 39 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) for the Primary Staging of Prostate Cancer in Australia

et al. 2022

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Background and Objectives Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. Perspective Australian healthcare perspective. Setting Tertiary. Methods A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). ResultsThe deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/qualityadjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. Conclusions PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

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“…Australian cancer costing studies using individual-level information have focused on specific cancer types in specific geographical locations, including prostate, lung and skin cancers in NSW [ 9 – 11 ] and colorectal cancer in Victoria [ 12 ]. The latter study highlighted the impact of specific new drugs on treatment costs for advanced colorectal cancer, estimated to add over AUD$10,000 for each case using bevacizumab or cetuximab.…”

Section: Introductionmentioning

confidence: 99%

Health services costs for cancer care in Australia: Estimates from the 45 and Up Study

Goldsbury¹,

Yap²,

Weber

et al. 2018

PLoS ONE

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BackgroundCancer care represents a substantial and rapidly rising healthcare cost in Australia. Our aim was to provide accurate population-based estimates of the health services cost of cancer care using large-scale linked patient-level data.MethodsWe analysed data for incident cancers diagnosed 2006–2010 and followed to 2014 among 266,793 eligible participants in the 45 and Up Study. Health system costs included Medicare and pharmaceutical claims, inpatient hospital episodes and emergency department presentations. Costs for cancer cases and matched cancer-free controls were compared, to estimate monthly/annual excess costs of cancer care by cancer type, before and after diagnosis and by phase of care (initial, continuing, terminal). Total costs incurred in 2013 were also estimated for all people diagnosed in Australia 2009–2013.Results7624 participants diagnosed with cancer were matched with up to three controls. The mean excess cost of care per case was AUD$1,622 for the year before diagnosis, $33,944 for the first year post-diagnosis and $8,796 for the second year post-diagnosis, with considerable variation by cancer type. Mean annual cost after the initial treatment phase was $4,474/case and the mean cost for the last year of life was $49,733/case. In 2013 the cost for cancers among people in Australia diagnosed during 2009–2013 was ~$6.3billion (0.4% of Gross Domestic Product; $272 per capita), with the largest costs for colorectal cancer ($1.1billion), breast cancer ($0.8billion), lung cancer ($0.6billion) and prostate cancer ($0.5billion).ConclusionsThe cost of cancer care is substantial and varies by cancer type and time since diagnosis. These findings emphasise the economic importance of effective primary and secondary cancer prevention strategies.

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Long-term health care costs for patients with prostate cancer: a population-wide longitudinal study in New South Wales, Australia

Cited by 12 publications

References 23 publications

Efficacy of tadalafil against lower urinary tract symptoms after low-dose-rate brachytherapy in prostate cancer patients

Efficacy of tadalafil against lower urinary tract symptoms after low-dose-rate brachytherapy in prostate cancer patients

Cost-Effectiveness Analysis of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) for the Primary Staging of Prostate Cancer in Australia

Health services costs for cancer care in Australia: Estimates from the 45 and Up Study

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