MP39-07 OUT-OF-POCKET COST AMONG PROSTATE CANCER RISK GROUPS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP39-07 OUT-OF-POCKET COST AMONG PROSTATE CANCER RISK GROUPS Ravishankar Jayadevappa, Joseph Gallo, Thomas Guzzo, Knashawn Morales, Neha Vapiwala, Keith Van Arsdalen, Alan Wein, S Bruce Malkowicz, and Sumedha Chhatre Ravishankar JayadevappaRavishankar Jayadevappa More articles by this author , Joseph GalloJoseph Gallo More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Knashawn MoralesKnashawn Morales More articles by this author , Neha VapiwalaNeha Vapiwala More articles by this author , Keith Van ArsdalenKeith Van Arsdalen More articles by this author , Alan WeinAlan Wein More articles by this author , S Bruce MalkowiczS Bruce Malkowicz More articles by this author , and Sumedha ChhatreSumedha Chhatre More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003277.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While financial toxicity such as out-of-pocket cost and indirect cost facing men with prostate cancer is acknowledged, it remains understudied. We assessed the out-of-pocket burden by treatment type across low, intermediate and high risk prostate cancer groups. METHODS: We used data from a multi-centered randomized controlled study among localized prostate cancer patients. Patient reported Out-of-pocket, and generic and prostate-cancer specific HRQoL outcomes were assessed at baseline, and at 3, 6, 12 and 24-month follow-up. Treatments were robotic-assisted laparoscopic radical prostatectomy (RALP), radiation therapy (RT) and active surveillance (AS). Participants were categorized into risk groups as: low risk (PSA <10 ng/ml, Gleason ≤ 6, clinical stage T1-2a), intermediate risk (PSA 10 -20 ng/ml, Gleason 7, clinical stage T2b), and high risk (PSA > 20, Gleason ≥8, clinical stage T2c-3a). Out-of-pocket and indirect costs were compared by treatment type, for each risk category. Linear mixed models were applied to study the association between out-of-pocket costs, treatment and HRQoL outcomes. RESULTS: Total of 743 localized prostate cancer patients were recruited for the study. Retention rate was > 75% during follow-up. 34% patients were low-risk, 32% were intermediate-risk and 34% were high-risk. For all risk groups, proportion of patients with out-of-pocket cost increased between baseline and 24-month, for all treatment types. Total mean of-of-pocket costs varied between RALP group and RT group at 3-month ($6782 vs. $3201), 6-month ($2873 vs. $4132), 12-month ($856 vs. $928), and at 24-month follow-up ($634 vs. $832). Linear mixed models indicated that RALP was associated with lower medication costs (OR=0.76, CI=0.52–0.91) and total out-of-pocket costs (OR=0.78, CI=0.61–0.92). Total out-of-pocket costs were inversely related to most of the generic and prostate cancer specific HRQoL items. CONCLUSIONS: This is one of the largest study that has assessed the patient reported out-of-pocket costs localized prostate cancer patients over 24 months of follow-up period. We observed that out-of-pocket of prostate cancer care are substantial and vary across risk and treatment groups. Especially, in the follow-up period, the proportion of patients with out-of-pocket cost increased significantly. Patient-centered survivorship care strategies are needed to reduce financial toxicity and improve outcomes in prostate cancer care. Source of Funding: PCORI CE-12-11-4973 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e537 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ravishankar Jayadevappa More articles by this author Joseph Gallo More articles by this author Thomas Guzzo More articles by this author Knashawn Morales More articles by this author Neha Vapiwala More articles by this author Keith Van Arsdalen More articles by this author Alan Wein More articles by this author S Bruce Malkowicz More articles by this author Sumedha Chhatre More articles by this author Expand All Advertisement PDF downloadLoading ...