The Cost of Prostatic Cancer in a Defined Population

Carlsson, Per; Hjertberg, Hans; Jönsson, B; Varenhorst, Eberhard

doi:10.3109/00365598909180819

Cited by 37 publications

(29 citation statements)

References 3 publications

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“…Substitution of hospital admissions with ambulant visits would not significantly reduce the expenses because nearly two-thirds (62%) of the patients had at most two hospital admissions and were treated within the first year (66%) or second year (78%) of diagnosis. In accordance with three other Scandinavian studies (12)(13)(14), we found that the average consumption of health-service resources in many terms was concentrated (3 times higher) in the group of patients who finally died from prostate cancer. Our study is also in agreement with Otnes et al (12) and Aus et al (13) in terms of hospital care requirements measured as median admission time (28 days).…”

Section: Burden To the Health-care Systemsupporting

confidence: 92%

The Dilemma of Prostate Cancer:A Growing Human and Economic Burden Irrespective of Treatment Strategies

1997

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Section: Burden To the Health-care Systemsupporting

confidence: 92%

The Dilemma of Prostate Cancer:A Growing Human and Economic Burden Irrespective of Treatment Strategies

1997

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“…6 He also noted that the survival time did not affect the total cost. This is felt to be secondary to the fact that most palliative, and expensive, procedures are required during that last year of life when local tumor growth or metastases require treatment.…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma of the prostate: an expensive way to die

Piper

Kusada

Lance

et al. 2002

Prostate Cancer Prostatic Dis

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The costs of radical prostatectomy and radiation therapy for localized carcinoma of the prostate are well known, the costs of terminal care for men with metastatic disease less so. We sought to determine the costs of terminal care incurred with prostate cancer in the last year of life. A retrospective chart review was conducted at five military medical centers identifying 32 patients who had died from prostate cancer from 1995 to 1997. The data investigated were: duration of metastatic disease, days hospitalized in the last year of life, palliative procedures (surgery or radiation), chemotherapy and need for transfusions. The mean duration of symptomatic metastatic disease was 3.4 y. The mean duration of hospitalization in the last year of life was 19 days. Seven patients (22%) required channel transurethral resection of the prostate (TURP). Three patients (9%) required either percutaneous nephrostomies or stenting. The mean number of transfusions required was 5.4. Eighteen patients (56%) underwent bilateral simple orchiectomy (BSO), 14 (44%) used LHRH agonists and 11 (34%) used antiandrogens. The mean total cost of hospitalization, studies, outpatient visits to physicians, palliative procedures and hormonal therapy was $24 660 in the last year of life. Comparatively, the cost of radical prostatectomy is $12 250 and threedimensional conformal radiation therapy is $13 823. Our estimation of costs due to metastatic disease is at best an underestimation. Men dying of prostate cancer incur significant costs in the last year of life. Based upon recent epidemiological data the cost of death due to prostate cancer in the US is over three quarters of a billion dollars a year.

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“…Uno dei primi tentativi di stima del costo diretto sanitario determinato dal CP è stato effettuato da Carlsson nel 1989 [17]. Carlsson calcolò il consumo di risorse sanitarie dalla diagnosi di CP fino al decesso in 101 pazienti deceduti tra il 1984 e il 1985 in Svezia (54% con carcinoma avanzato già alla diagnosi).…”

Section: Aspetti Economici Del Cancro Della Prostataunclassified

“…Nel semestre in cui si verifica la diagnosi i costi sanitari ammontano a circa 10-14.000 dollari [73,77] in relazione soprattutto ai ricoveri e pertanto al tipo di trattamento (combinazione di chirurgia e terapia medica vs singole strategie), ma anche alla comorbidità, al reddito e all'area geografica. Il periodo che precede strettamente il semestre in cui si verifica il decesso ha anch'esso una maggiore intensità di cure sanitarie, con un costo che si aggira sui 7-8.000 dollari/anno [77], mentre nel semestre terminale i costi variano da 11.000 dollari a 13.000 dollari, in ragione della causa di morte, della comorbidità e dello stadio iniziale della malattia [13,17,33,41,72,77,96]. Non ci sono, purtroppo, analisi economiche specifiche per lo scenario sanitario italiano attuale.…”

Section: Aspetti Economici Del Cancro Della Prostataunclassified

Considerazioni cliniche ed economiche nel trattamento del cancro della prostata: analisi costo-efficacia di bicalutamide vs flutamide in combinazione con LHRH

Marchetti

Colombo²

2003

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INTRODUZIONEIl carcinoma prostatico (CP) è la neoplasia maligna di più frequente riscontro nella popolazione maschile sopra i 65 anni, rappresentando comunque il 12% delle neoplasie che colpiscono la popolazione maschile di ogni età [9]. Agli inizi degli anni novanta le nuove diagnosi di CP sono notevolmente aumentate; in Italia, l'incidenza di questa neoplasia è di 60/100,000/ anno [26], pari a circa 11.000 nuovi casi all'anno. Questo fenomeno deriva soprattutto dell'applicazione di metodiche di screening, ma anche dall'allungamento della vita media e dal conseguente aumento della popolazione anziana, il 14-48% della quale risulta istologicamente portatrice di CP [102].Il CP è una neoplasia a lenta evoluzione, potendosi prevedere in media una durata di malattia di 8-14 anni, in relazione sia allo stadio di malattia alla diagnosi, ma soprattutto alla presenza e al tipo delle comorbidità. Infatti, la mortalità specifica per malattia riguarda solo il 47% della mortalità globale nei pazienti con CP [77]. ABSTRACTProstate carcinoma (PC) is the most common malign neoplasm found in men over 65 years of age. In Italy, the incidence of this cancer is around 60/100,000/year, corresponding to about 11,000 new cases each year. Patients with PC consume health resources for a cost that is 10-24% higher than that of similar populations without PC. It is estimated that in Italy, each year, there are 19,000 hospitalizations for prostate cancer in patients over 65, a figure that represents 4% of the total hospitalizations for oncological diseases. We conducted a marginal cost/effectiveness analysis of bicalutamide vs. flutamide, both administered in combination with LHRH, in patients with advanced (metastatic) PC, on the basis of a randomized trial comparing 4 strategies of total androgenic blockade (TAB). The analysis was conducted in the perspective of the SSN (National health system). The comparison revealed that drug acquisition costs are not the only determinants of the economical differences between the two therapeutical strategies. Furthermore, we demonstrated that prolonged survival of the patients does not increase the consumption of health resources, since the chronological shift of the terminal phase reduces the value of the resources dedicated to it. When conducing the cost/effectiveness analysis, the survival advantage associated to bicalutamide has been adjusted to balance the low quality of life of PC patients. The pharmacoeconomical benefit of bicalutamide resulted of 12,150 Euro/QALY, while the cost per year of life saved resulted inferior, ranging from 8.327 to 11.440 Euro. This cost/QALY value is nevertheless lower than that associated to several therapeutical strategies that are commonly accepted in developed countries (domiciliar hemodialysis, heart transplantation, breast cancer screening, etc.). Considering that 12.150 Euro/QALY is the highest estimate of the relative cost/effectiveness of bicalutamide, it appears that the combination bicalutamide + LHRH represents an economically acceptable alternative to...

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The Cost of Prostatic Cancer in a Defined Population

Cited by 37 publications

References 3 publications

The Dilemma of Prostate Cancer:A Growing Human and Economic Burden Irrespective of Treatment Strategies

The Dilemma of Prostate Cancer:A Growing Human and Economic Burden Irrespective of Treatment Strategies

Adenocarcinoma of the prostate: an expensive way to die

Considerazioni cliniche ed economiche nel trattamento del cancro della prostata: analisi costo-efficacia di bicalutamide vs flutamide in combinazione con LHRH

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