Economic Burden Of Prostate Cancer Research Articles

Finding the PSA-based screening stopping age using prostate cancer risk

BackgroundProstate Cancer screening was not rational for people who were suffered from other serious diseases and had a low quality of life. Biopsy and Prostate-Specific Antigen based screening also had imperfect information, pain, and costs. Finding the Prostate Cancer screening stopping age was important because after an age, Prostate-Specific Antigen test was not recommended and patients should not perform subsequent procedures. It could reduce the economic burden of Prostate Cancer. In this study, we modeled the effects of Prostate Cancer risk and comorbidities on the Prostate Cancer screening stopping age. Methodsfirst, using a Markov model for PC progression, we provided a model for optimal Prostate Cancer screening stopping age. Second, we explored the relationship between comorbidities effects, Prostate Cancer risk and the stopping age. ResultsOur results suggest that the stopping age was an increasing function of PC risk and comorbidities effects. Screening should be stopped before 70 years. Finding showed that for men with diseases such as stroke or heart diseases, screening should not be performed at any age. ConclusionsPersonalizing PC screening through paying more attention to PC risk can improve efficiency of screening. The role of personal characteristics such as race, family history, and previous PSA in PC screening decision-making was highlighted by stratifying men in different PC risk groups to find their stopping age. Incorporating comorbidity effects shows that severity of comorbidity was a crucial factor in PC screening stopping age decision-making process.

The economic burden of prostate cancer in Eswatini

BackgroundProstate cancer is the fifth cause of cancer mortality among men worldwide. However, there is limited data on costs associated with prostate cancer in low- and middle-income countries particularly in the sub-Saharan region. From a societal perspective, this study aims to estimate the cost of prostate cancer in Eswatini.MethodsThis prevalence–based cost-of-illness study used diagnosis specific data from national registries to estimate costs associated to prostate cancer during 2018. The prevalence-based approach was used employing both top down and bottom up costing approaches. Costs data included health care utilization, transport, sick leave days and premature death.ResultsThe total annual cost of prostate cancer was $6.2 million (ranging between $ 4.7 million and 7.8 million estimated with lower and upper bounds). Average cost-per patient for radiotherapy, chemotherapy and other non-medical direct costs (transport and lodging) were the highest cost drivers recording $16,648, $7,498 and $5,959 respectively whilst indirect costs including productive loss due to sick leave and pre-mature mortality was estimated at $58,320 and $113,760 respectively. Cost of managing prostate cancer increased with advanced disease and costs were highest for prostate cancer stages III and IV recording $1.1million, $1.9million respectively.ConclusionsProstate cancer is a public health concern in Eswatini, and it imposes significant economic burden to the society. This finding point areas for policy makers to perform cost containment regarding therapeutic procedures for prostate cancer and the need for strategies to increase efficiencies in the health care systems for increased value for health care services.

The economic burden of prostate cancer \u2013 a Swedish prevalence-based register study

BackgroundIncidence and prevalence of prostate cancer in Sweden have increased markedly due to prostate-specific antigen (PSA) testing. Moreover, new diagnostic tests and treatment technologies are expected to further increase the overall costs. Our aims were (i) to estimate the societal costs for existing testing, diagnosis, management and treatment of prostate cancer, and (ii) to provide reference values for future cost-effectiveness analyses of prostate cancer screening and treatment.MethodsTaking a societal perspective, this study aimed to investigate the annual cost of prostate cancer in Sweden using a prevalence-based cost-of-illness approach. Resource utilisation and related costs within Stockholm Region during 2016 were quantified using data from the Stockholm PSA and Biopsy Register and other health and population registers. Costs included: (i) direct medical costs for health care utilisation at primary care, hospitals, palliative care and prescribed drugs; (ii) informal care; and (iii) indirect costs due to morbidity and premature mortality. The resource utilisation was valued using unit costs for direct medical costs and the human capital method for informal care and indirect costs. Costs for the Stockholm region were extrapolated to Sweden based on cancer prevalence and the average costs by age and resource type.ResultsThe societal costs due to prostate cancer in Stockholm in 2016 were estimated to be €64 million Euro (€Mn), of which the direct medical costs, informal care and productivity losses represented 62, 28 and 10% of the total costs, respectively. The total annual costs extrapolated to Sweden were calculated to be €281 Mn. The average direct medical cost, average costs for informal care and productivity losses per prevalent case were €1510, €828 and €271, respectively. These estimates were sensitive to assumptions related to the proportion of primary care visits associated with PSA testing and the valuation method for informal care.ConclusionThe societal costs due to prostate cancer were substantial and constitute a considerable burden to Swedish society. Data from this study are relevant for future cost-effectiveness evaluations of prostate cancer screening and treatment.

Economic burden of illness associated with localized prostate cancer in the United States.

Aim: Prior studies have established the economic burden of prostate cancer on society. However, changes to screening, novel therapies and increased use of active surveillance (AS) create a need for an updated analysis. Methods: A deterministic, decision-analytic model was developed to estimate medical costs associated with localized prostate cancer over 10years. Results: 10-year costs averaged $45,957, $99,445 and $188,928 for low-, intermediate- and high-risk patients, respectively. For low-risk patients, AS 10-year costs averaged $33,912/patient, whereas definitive treatment averaged $49,667/patient. Despite higher failure rates in intermediate-risk patients, AS remained less costly than definitive treatment, with 10-year costs averaging $90,614/patient and $99,394/patient, respectively. Conclusion: Broader incorporation of AS, guided by additional prognostic tools, may mitigate this growing economic burden.

Economic Burden of Prostate Cancer in Iran: Measuring Costs and Quality of Life

Background: Prostate cancer (PCa) is the third most diagnosed cancer among men in Iran with approximately 4200 new cases in 2015. Considering the rapid growth of cancer diagnosis, this study aims to investigate the economic burden of PCa patients and their health-related quality of life (HRQoL) Methods: A retrospective survey was conducted on 500 registered patients to discover the pattern of care and distribution of patients in the main treatment categories. In the next step, a multi-center survey of the patients under treatment was conducted. The objective of this survey was to estimate direct medical costs (DMC), non-medical costs, and productivity losses for patients and family members. HRQoL was measured by the Functional Assessment of Cancer Therapy–Prostate questionnaire. Results: Despite high age of patients (72±9.25 years), only 53.3% of them were retired or disabled. The largest proportion of patients (54.3%) received medicinal or surgical hormone therapy. Radical prostatectomy was the main treatment for 31.7% of patients, 10.2% received radiation therapy, and 3.8% underwent chemotherapy. DMC for incident population was approximately 12.5 million US dollars/year, and the highest average cost per capita belonged to chemotherapy patients. Unpredictably, productivity loss was nearly as much as direct cost. The mean score for HRQoL was 0.62±0.16 for all patients. Orchiectomy group had the lowest HRQoL score (0.55±0.16). Chemotherapy patients suffered the worst scores in the physical well-being subscale (0.47±0.24). Hormone therapy patients had the least scores in the prostate-specific subscale (0.50±0.18). Conclusion: The economic burden of PCa is estimated approximately 25.8 million US dollars per year for incident population. When we refer to the high proportion of patients diagnosed in advanced state of the disease and higher per capita cost for these patients, policy makers should promote screening strategies to control health care costs and to increase both life expectancy and HRQoL.

Practical differences between luteinizing hormone-releasing hormone agonists in prostate cancer: perspectives across the spectrum of care.

Androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists is well established for the treatment of men with metastatic prostate cancer. As clear differences in efficacy, safety, or tolerability between the available LHRH agonists are lacking, the healthcare management team needs to look to practical differences between the formulations when selecting therapy for their patients. Moreover, as the economic burden of prostate cancer rises alongside earlier diagnosis and improved survival, the possibility for cost savings by using products with specific features is growing in importance. A review was conducted to summarize the information on the different LHRH agonist formulations currently available and offer insight into their relative benefits and disadvantages from the perspectives of physicians, a pharmacist, and a nurse. The leuprorelin acetate and goserelin acetate solid implants have the advantage of being ready to use with no requirement for refrigeration, whereas powder and microsphere formulations have to be reconstituted and have specific storage or handling constraints. The single-step administration of solid implants, therefore, has potential to reduce labor time and associated costs. Dosing frequency is another key consideration, as administering the injection provides an opportunity for face-to-face interaction between the patient and healthcare professionals to ensure therapy is optimized and give reassurance to patients. Prostate cancer patients are reported to prefer 3- or 6-monthly dosing, which aligns with the monitoring frequency recommended in European Association of Urology guidelines and has been shown to result in reduced annual costs compared with 1-month formulations. A number of practical differences exist between the different LHRH agonist preparations available, which may impact on clinical practice. It is important for healthcare providers to be aware and carefully consider these differences when selecting treatments for their prostate cancer patients.

Cost-effectiveness analysis of magnetic resonance imaging-ultrasound fusion biopsy versus systematic transrectal ultrasound-guided biopsy in diagnosing prostate cancer.

25 Background: We sought to determine if the reported improved performance of magnetic resonance imaging-ultrasound (MRI-US) fusion biopsy over systematic transrectal ultrasound-guided biopsy (TRUS) in the detection of prostate cancer justifies the added cost of the MR imaging. Methods: A decision-analytic Markov model with a lifetime horizon of 10 years was developed to evaluate diagnostic accuracy, long-term health outcomes, costs, and quality-of-life of two strategies (i.e., TRUS versus MRI-US fusion biopsy [prostate MRI followed potentially by MRI-US fusion biopsy]) as the initial diagnostic test in men with elevated prostate-specific antigen ( > 4 ng/ml) without prior evaluation. Probabilities of clinical events were obtained from published literature. Direct medical costs, including diagnostic and treatment-related costs, were derived from the Premier Hospital Database. Costs were inflated to 2015 US dollars and discounted at an annual rate of 3%. Health outcomes were measured in quality-adjusted life years (QALYs), which were determined based on published literature and expert opinion. We calculated the incremental cost-effectiveness ratio and performed sensitivity analyses to assess uncertainty. Results: The MRI-US fusion biopsy strategy yielded a lower average discounted cost ($5,358 versus $6,372) and higher total QALYs-gained (7.21 versus 7.19) than TRUS. The reduced expenditures associated with MRI-US fusion biopsy was primarily due to avoiding intervention for clinically insignificant prostate cancer. The results were robust with the sensitivity analyses. Conclusions: For men in the United States with an elevated PSA, the use of MRI-US fusion biopsy in the evaluation for prostate cancer represents a greater value than TRUS, the standard of care option. Widespread adoption of MRI-US fusion biopsy may serve to reduce the economic burden of prostate cancer.

PCN102 - Assessing The Clinical And Economic Burden of Prostate Cancer in The United States Veteran Population

To assess the clinical burden, health care utilization, and cost patterns of prostate cancer patients in the US veteran population. Patients diagnosed with prostate cancer (International Classification of Diseases, Ninth Revision, Clinical Modification code: 185.xx) were selected from the Veterans Health Administration (VHA) database (October 1, 2010-September 30, 2014). The first observed diagnosis date was defined as the index date. Continuous medical and pharmacy benefits were required 12 months pre- and post-index date. The 10 most common comorbidities were calculated for the 12-month baseline period. The 10 most commonly prescribed medications were calculated for 60 days post-index date. Health care resource utilization (inpatient, outpatient, pharmacy) and costs (inpatient, outpatient, pharmacy, total) were assessed for the 12-month follow-up period. Descriptive statistics were calculated as means ± standard deviation (SD) and percentages to measure treatment, cost, and utilization distribution in the sample. Among all study patients diagnosed with prostate cancer (n=195,989), the most common comorbidities were hypertension (24.24%), elevated prostate-specific antigen (PSA) levels (22.26%), diabetes (13.96%), bilateral hearing loss (8.19%), and hyperlipidemia (7.95%). The most commonly prescribed medications for prostate cancer patients were simvastatin (16.95%), lisinopril (14.62%), omeprazole (13.43%), amlodipine besylate (11.05%), and hydrochlorothiazide (7.56%). The percentage of patients with inpatient stays (12.24%), outpatient visits (99.88%), and pharmacy visits (85.26%) were calculated. Prostate cancer patients incurred $4,488 (SD=$27,143) in inpatient, $8,690 (SD=$13,923) in outpatient visit, and $1,296 (SD=$4,839) in pharmacy costs. Total expenditures were $14,474 (SD=$34,318). Results suggest that hypertension and elevated PSA levels were the most common comorbidities among prostate cancer patients. This disease is associated with high outpatient visit utilization, resulting in a high cost burden.

PCN77 - Economic Burden of Prostate Cancer in Iran

PCN77 - Economic Burden of Prostate Cancer in Iran

PCN112 - Clinical and Economic Burden of Prostate Cancer

PCN112 - Clinical and Economic Burden of Prostate Cancer

Financial toxicity: a potential side effect of prostate cancer treatment among Australian men.

The purpose of this study was to understand the extent, nature and variability of the current economic burden of prostate cancer among Australian men. An online cross‐sectional survey was developed that combined pre‐existing economic measures and new questions. With few exceptions, the online survey was viable and acceptable to participants. The main outcomes were self‐reported out‐of‐pocket costs of prostate cancer diagnosis and treatment, changes in employment status and household finances. Men were recruited from prostate cancer support groups throughout Australia. Descriptive statistical analyses were undertaken. A total of 289 men responded to the survey during April and June 2013. Our study found that men recently diagnosed (within 16 months of the survey) (n = 65) reported spending a median AU$8000 (interquartile range AU$14 000) for their cancer treatment while 75% of men spent up to AU$17 000 (2012). Twenty per cent of all men found the cost of treating their prostate cancer caused them ‘a great deal’ of distress. The findings suggest a large variability in medical costs for prostate cancer treatment with 5% of men spending $250 or less in out‐of‐pocket expenses and some men facing very high costs. On average, respondents in paid employment at diagnosis stated that they had retired 4–5 years earlier than planned.

The economic burden of prostate cancer. A systematic literature overview of registry-based studies

Prostate cancer, the most frequent malignant disease in males in Europe, accounts for a great proportion of health expenditures. A systematic review of registry-based studies about the cost-of-illness and related factors of prostate cancer, published in the last 10 years. A MEDLINE-based literature review was carried out between January 1, 2003 and October 1, 2013. Fifteen peer-reviewed articles met the criteria of interest. In developed countries radiotherapy, surgical treatment and hormone therapy account for the greatest per capita costs. In Europe early stage tumours (4-7000 €, 2006), while in the USA metastatic prostate cancer (19 900-25 500 $, 2004) was associated with highest per capita expenses. In Europe the greatest costs incurred within the initial treatment (6400 €/6 months, 2008), while in the USA within the end-of-life care (depending on age: 62 200-93 400 $, 2010). Despite public health importance of prostate cancer, the cost-of-illness literature from Europe is relatively small.

PCN50 - Assessing The Clinical And Economic Burden Of Prostate Cancer In The Veteran Population In The United States

PCN50 - Assessing The Clinical And Economic Burden Of Prostate Cancer In The Veteran Population In The United States

The burden of prostate cancer in Canada

The clinical and economic burden of prostate cancer in Canada is substantial, and is rising. Studies indicate that 1 in 7 men will develop prostate cancer during their lifetime, and another 1 in 27 will die because of it. It is estimated that 4300 Canadian men will die of prostate cancer in 2008. Age, family history, race and diet are all risks associated with the development of prostate cancer. A diagnosis of cancer carries a significant burden and like other cancers is a cause of significant anxiety and depression. Uncertainty regarding the value of screening for prostate cancer has been, and continues to be, a challenge for primary care physicians and urologists.

PHS3 Assessing the Survival Rates and Economic Burden of Prostate Cancer in the United States Veteran Population

PHS3 Assessing the Survival Rates and Economic Burden of Prostate Cancer in the United States Veteran Population

PCN57 Economic Burden of Prostate Cancer in Russia

PCN57 Economic Burden of Prostate Cancer in Russia

Economic Analysis: Randomized, Placebo-Controlled Clinical Trial of Dutasteride in Men at High Risk for Prostate Cancer

Objective: Given the economic burden of prostate cancer (PCa), a PCa risk-reduction medication would be desirable. A within-trial economic analysis of the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study was performed. Methods: REDUCE, a 4-year, randomized, double-blind, placebo-controlled, parallel-group clinical trial, compared efficacy and safety of dutasteride 0.5 mg daily and placebo to reduce the risk of PCa in men at increased risk. Resource use was prospectively collected; costs from standard costing sources were applied. Utilities were obtained from published literature. Relative risks and Wilcoxon rank sums were used to examine differences between treatments. Results: Placebo patients were at significantly higher risk (P < 0.05) for concomitant medication use; and health care visits related to surgical procedures, unscheduled biopsies, acute urinary retention, urinary tract infections, or macroscopic hematuria. Total costs were significantly lower (P < 0.001) in dutasteride patients ($1 300; 95% confidence interval: $806, $1 795). Incremental cost per quality-adjusted life-year (QALY) was $26 516; cost per PCa case avoided was $19. Conclusions: During the 4-year trial period, men at increased risk for PCa receiving dutasteride incurred fewer health care costs than men receiving placebo, which helped offset dutasteride costs. Dutasteride was good value for money.

Lifetime economic burden of prostate cancer

BackgroundProstate cancer (PCa) is the most common cancer affecting men in the United States. The initial treatment and subsequent monitoring of PCa patients places a large burden on U.S. health care systems. The objectives of this study were to estimate the total and disease-related per-patient lifetime costs using a phase-based model of cancer care for PCa patients enrolled in Medicare.MethodsA model was developed to estimate life-time costs for patients diagnosed with PCa. Patients ≥ 65 years old and diagnosed with PCa between calendar years 1991-2002 were selected from the SEER database. Using SEER, we estimated survival times for PCa patients from diagnosis until death. The period of time patients contributed to treatment phases was determined using an algorithm designed to model the natural history of PCa. Costs were obtained from the US SEER-Medicare database and estimated during specific phases of care. Cost estimates were then combined with survival data to yield total and PCa-related life-time costs.ResultsOverall, the model estimated life-time costs of $110,520 (95% CI 110,324-110,739) per patient. PCa-related costs made up approximately 31% of total costs ($34,432).ConclusionsProstate cancer places a significant burden on U.S. health-care systems with average life-time PCa-related costs in excess of $30,000.

The economic burden of prostate cancer

In the present review we discuss expenditure on prostate cancer diagnosis, treatment and follow-up and evaluate the cost of prostate cancer and its management in different countries. Prostate cancer costs were identified from published data and internet sources. To provide up-to-date comparisons, costs were inflated to 2010 levels and the most recent exchange rates were applied. A high proportion of the costs are incurred in the first year after diagnosis; in 2006, this amounted to 106.7-179.0 million euros (€) in the European countries where these data were available (UK, Germany, France, Italy, Spain and the Netherlands). In the USA, the total estimated expenditure on prostate cancer was 9.862 billion US dollars ($) in 2006. The mean annual costs per patient in the USA were $10,612 in the initial phase after diagnosis, $2134 for continuing care and $33,691 in the last year of life. In Canada, hospital and drug expenditure on prostate cancer totalled C$103.1 million in 1998. In Australia, annual costs for prostate cancer care in 1993-1994 were 101.1 million Australian dollars. Variations in costs between countries were attributed to differences in incidence and management practices. Per patient costs depend on cancer stage at diagnosis, survival and choice of treatment. Despite declining mortality rates, costs are expected to rise owing to increased diagnosis, diagnosis at an earlier stage and increased survival. Unless new strategies are devised to increase the efficiency of healthcare provision, the economic burden of prostate cancer will continue to rise.

A retrospective analysis illustrating the substantial clinical and economic burden of prostate cancer

The aim of this study was to determine the treatment patterns and resource utilization of various prostate cancer treatments, and quantify the economic and clinical impact of each. In a retrospective analysis of medical and pharmacy claims between 2000 and 2005, using the PharMetrics database, male patients aged > or =40 years with prostate cancer diagnosis were identified. The costs of medical and prostate cancer-related expenditures for the treatment options were determined for three periods: from diagnosis to first treatment, during and after treatment. A total of 9035 patients were included. The mean age of patients diagnosed with prostate cancer was 61.4 years. Patients aged 50-59 years represented the highest proportion at 51%. The majority received some form of treatment. Watchful waiting (WW) was the primary means of management for 30%. The average 2-year cost for WW was $24 809 and for active treatment was $59, 286. Surgery was the most common treatment among younger men. Non-cancer-related costs were similar among those receiving treatment or WW, but prostate cancer costs were over five times greater in the treated patients. With or without treatment, prostate cancer is a significant clinical and economic burden to society. New strategies for treatment or cancer prevention could play a role in reducing this burden.