Lifetime economic burden of prostate cancer

Michael E Stokes, Jack Ishak, Irina Proskorovsky, Libby K Black, Yijian Huang, Michael E Stokes, Jack Ishak, Irina Proskorovsky, Libby K Black, Yijian Huang

Abstract

Background: Prostate 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.

Methods: A 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.

Results: Overall, 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).

Conclusions: Prostate cancer places a significant burden on U.S. health-care systems with average life-time PCa-related costs in excess of $30,000.

References

    1. Ries L, Melbert D, Krapcho M, et al, editor. SEER Cancer Statistics Review, 1975-2005. Bethesda: National Cancer Institute; 2006. Table I-21, US Prevalence Counts, Invasive Cancers Only, January 1, 2005, Using Different Tumor Inclusion Criteria.
    1. American Cancer Society. Cancer Facts and Figures. 2008.
    1. National Cancer Institute. Surveillance Epidemiology and End Results (SEER) Stat Fact Sheets: Prostate. Bethesda: National Cancer Institute; 2011.
    1. National Cancer Institute. Cancer Trends Progress Report - 2007 Update. Bethesda: National Cancer Institute; 2008.
    1. Andriole G, Bostwick D, Brawley O, Gomella L, Marberger M, Tindall D, Breed S, Somerville M, Rittmaster R. Chemoprevention of prostate cancer in men at high risk: rationale and design of the reduction by dutasteride of prostate cancer events (REDUCE) trial. J Urol. 2004;172(4 Pt 1):1314–1317.
    1. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, Lieber MM, Cespedes RD, Atkins JN, Lippman SM. et al.The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003;349(3):215–224. doi: 10.1056/NEJMoa030660.
    1. Brown ML, Riley GF, Potosky AL, Etzioni RD. Obtaining long-term disease specific costs of care: application to Medicare enrollees diagnosed with colorectal cancer. Med Care. 1999;37(12):1249–1259. doi: 10.1097/00005650-199912000-00008.
    1. National Cancer Institute. Surveillance Epidemiology and End Results. Bethesda: National Cancer Institute; 2009. Overview of the SEER Program.
    1. Brenner H, Arndt V. Long-term survival rates of patients with prostate cancer in the prostate-specific antigen screening era: population-based estimates for the year 2000 by period analysis. J Clin Oncol. 2005;23(3):441–447.
    1. Arias E. United States life tables, 2004. Natl Vital Stat Rep. 2007;56(9):1–39.
    1. Baker MS, Kessler LG, Urban N, Smucker RC. Estimating the treatment costs of breast and lung cancer. Med Care. 1991;29(1):40–49. doi: 10.1097/00005650-199101000-00004.
    1. Stokes ME, Black L, Benedict A, Roehrborn CG, Albertsen P. Long-term medical-care costs related to prostate cancer: estimates from linked SEER-Medicare data. Prostate Cancer Prostatic Dis. 2010.
    1. Efron B, Tibshirani R. An Introduction to the Bootstrap. New York: Chapman & Hall; 1993.
    1. Riley GF, Potosky AL, Lubitz JD, Kessler LG. Medicare payments from diagnosis to death for elderly cancer patients by stage at diagnosis. Med Care. 1995;33(8):828–841. doi: 10.1097/00005650-199508000-00007.
    1. Lin DW, Porter M, Montgomery B. Treatment and survival outcomes in young men diagnosed with prostate cancer: a Population-based Cohort Study. Cancer. 2009;115(13):2863–2871. doi: 10.1002/cncr.24324.
    1. Mathers MJ, Roth S, Klinkhammer-Schalke M, Gerken M, Hofstaedter F, Wilm S, Klotz T. Patients with localised prostate cancer (t1 - t2) show improved overall long-term survival compared to the normal population. J Cancer. 2011;2:76–80.
    1. Zeliadt SB, Etzioni R, Ramsey SD, Penson DF, Potosky AL. Trends in treatment costs for localized prostate cancer: the healthy screenee effect. Med Care. 2007;45(2):154–159. doi: 10.1097/01.mlr.0000241044.09778.3f.
    1. Chang S, Long SR, Kutikova L, Bowman L, Finley D, Crown WH, Bennett CL. Estimating the cost of cancer: results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000. J Clin Oncol. 2004;22(17):3524–3530. doi: 10.1200/JCO.2004.10.170.
    1. Cetin K, Beebe-Dimmer JL, Fryzek JP, Markus R, Carducci MA. Recent time trends in the epidemiology of stage IV prostate cancer in the United States: analysis of data from the Surveillance, Epidemiology, and End Results Program. Urology. 2010;75(6):1396–1404. doi: 10.1016/j.urology.2009.07.1360.
    1. Brown ML, Riley GF, Schussler N, Etzioni R. Estimating health care costs related to cancer treatment from SEER-Medicare data. Med Care. 2002;40(8 Suppl) IV-104-117.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit