Prostate cancer cost varies widely by treatment

The total cost burden of prostate cancer varies significantly by treatment type, according to a new report.

"I would like this information to be used by clinicians to emphasize that, especially, the initial costs of a prostate cancer treatment are not reflective of the full cost over time of the treatment and, therefore, should not be used to determine the best choice of treatment for a patient or in decisions of treatment insurance coverage," Dr. Leslie S. Wilson from University of California, San Francisco, told Reuters Health.

Wilson and colleagues compared patterns of healthcare utilization and direct costs of prostate cancer-related treatments over a 5.5-year period in 4553 newly diagnosed patients, stratified by age, risk group, and ethnic group

In the first 6 months after diagnosis, direct prostate-related costs per patient were high ($11,495) and highly variable ($2586 for watchful waiting to $24,204 for external-beam radiation therapy), the researchers report.

After the first 6 months, prostate-related costs were only $3044, ranging from $2418 for radical prostatectomy to $6019 for androgen deprivation therapy.

Cumulative costs for the entire period were highest for androgen deprivation therapy ($69,244) and external-beam radiation therapy ($59,455) and lowest for watchful waiting ($32,135) and brachytherapy ($35,143), the researchers note.

The most costly treatments were generally reserved for the highest risk groups, the report indicates, whereas the least costly treatments were primarily used by the lowest risk groups.

"Our data demonstrate that prostate-related costs per person are substantial and sustained over time, and that short-term treatment cost comparisons most commonly found in the literature do not truly reflect the cost of treatment choices over the long term," the investigators conclude.

SOURCE: Cancer, December online

"It appears that current treatment is following clinical treatment guidelines from our data," Dr. Wilson added. "Our paper also reminds us that it is important to examine the downstream costs (which indicate more care needs) of each of the different treatments."

SOURCE: Cancer, January 1, 2007.