[Cost comparison of three treatments for localized prostate cancer in Spain: radical prostatectomy, prostate brachytherapy and external 3D conformal radiotherapy]
Virginia Becerra Bachino, Francesc Cots, Ferran Guedea, Joan Pera, Ana Boladeras, Ferran Aguiló, José Francisco Suárez, Pedro Gallo, Lluis Murgui, Angels Pont, Oriol Cunillera, Yolanda Pardo, Montserrat Ferrer, Grupo Multicéntrico Español de Cáncer de Próstata Organoconfinado, Jordi Alonso, Montse Ferrer, Olatz Garín, Àngels Pont, Oriol Cunillera, Virginia Becerra Bachino, Yolanda Pardo, Ana Boladeras, Ferran Ferrer, Ferran Guedea, Victoria Eugenia Padin, Joan Pera, Montse Ventura, Ferran Aguiló, Jose Francisco Suárez, Sergio Pastor, Josep Maria Prats, Javier Ponce de León, Humberto Villavicencio, José Emilio Batista, Jordi Craven-Bartle, Gemma Sancho, Belen de Paula, Pablo Fernández, Benjamin Guix, Ismael Herruzo, Helena Hernández, Victor Munoz, Asunción Hervas, Alfredo Ramos, Víctor Macias, Pilar Marcos, Alfonso Marino, María Jose Ortiz, Virginia Becerra Bachino, Francesc Cots, Ferran Guedea, Joan Pera, Ana Boladeras, Ferran Aguiló, José Francisco Suárez, Pedro Gallo, Lluis Murgui, Angels Pont, Oriol Cunillera, Yolanda Pardo, Montserrat Ferrer, Grupo Multicéntrico Español de Cáncer de Próstata Organoconfinado, Jordi Alonso, Montse Ferrer, Olatz Garín, Àngels Pont, Oriol Cunillera, Virginia Becerra Bachino, Yolanda Pardo, Ana Boladeras, Ferran Ferrer, Ferran Guedea, Victoria Eugenia Padin, Joan Pera, Montse Ventura, Ferran Aguiló, Jose Francisco Suárez, Sergio Pastor, Josep Maria Prats, Javier Ponce de León, Humberto Villavicencio, José Emilio Batista, Jordi Craven-Bartle, Gemma Sancho, Belen de Paula, Pablo Fernández, Benjamin Guix, Ismael Herruzo, Helena Hernández, Victor Munoz, Asunción Hervas, Alfredo Ramos, Víctor Macias, Pilar Marcos, Alfonso Marino, María Jose Ortiz
Abstract
Objective: To compare the initial costs of the three most established treatments for clinically localized prostate cancer according to risk, age and comorbidity groups, from the healthcare provider's perspective.
Methods: We carried out a cost comparison study in a sample of patients consecutively recruited between 2003 and 2005 from a functional unit for prostate cancer treatment in Catalonia (Spain). The use of services up to 6 months after the treatment start date was obtained from hospital databases and direct costs were estimated by micro-cost calculation. Information on the clinical characteristics of patients and treatments was collected prospectively. Costs were compared by using nonparametric tests comparing medians (Kruskall-Wallis) and a semi-logarithmic multiple regression model.
Results: Among the 398 patients included, the cost difference among treatments was statistically significant: medians were € 3,229.10, € 5,369.00 and € 6,265.60, respectively, for the groups of patients treated with external 3D conformal radiotherapy, brachytherapy and radical retropublic prostatectomy, (p<0.001). In the multivariate analysis (adjusted R(2)=0.8), the average costs of brachytherapy and external radiotherapy were significantly lower than that of prostatectomy (coefficient -0.212 and -0.729, respectively).
Conclusions: Radical prostatectomy proved to be the most expensive treatment option. Overall, the estimated costs in our study were lower than those published elsewhere. Most of the costs were explained by the therapeutic option and neither comorbidity nor risk groups showed an effect on total costs independent of treatment.
Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
Source: PubMed