An economic evaluation of conservative management and cryotherapy in patients with localized prostate cancer. Issue 4 (7th August 2018)

• Record Type: Journal Article
• Authors: Shah, Surbhi; Young, Henry N; Cobran, Ewan K
• Is Part Of: Journal of pharmaceutical health services research. Volume 9:Issue 4(2018:Dec.)
• Page Start: 309
• Page End: 318
• Publication Date: 2018-08-07
• Subjects: pharmaco-economics; Pharmacy -- Research -- Periodicals; Drugs -- Research -- Periodicals; Medical care -- Research -- Periodicals; Public health -- Research -- Periodicals; Pharmaceutical industry -- Periodicals; Health Services Research -- Periodicals; Economics, Pharmaceutical -- Periodicals; 615.1072
• DOI: 10.1111/jphs.12248
• Languages: English
• ISSNs: 1759-8885

Abstract

Abstract: Objectives: Cost of care in localized prostate cancer varies widely with treatments and phases of care. This study aimed to evaluate the total direct medical costs and phase-specific costs associated with two minimally invasive treatment options (conservative management and cryotherapy) from Medicare perspective in patients with localized prostate cancer. Methods: The Surveillance, Epidemiology, and End Result program linked to the Medicare data from 2000 to 2014 was utilized. The total direct medical cost and phase-specific costs were calculated from Medicare's perspective. Phase-specific costs were divided into three phases: initial, continuing and terminal phases. Cost was presented at 2014 US dollar values. Nonparametric bootstrapping and generalized linear models with gamma distribution and log link function were performed. Key findings: The average total direct cost of cancer care in the conservative management and cryotherapy cohort was approximately $13 664 and $14 312 respectively. Compared to the cryotherapy cohort, patients in the conservative management cohort had significantly lower cost in the initial ($3708 versus $4780), continuing ($1504 versus $2253) and the terminal phases of care ($13 387 versus $15 532). Results from the generalized linear model showed that conservative management incurred significantly lower costs across all phases of care compared with cryotherapy after adjusting for the covariates. Conclusions: This study shows the importance of conservative management as a cost-saving strategy for patients with prostate cancer across all the phases of care. The findings could guide policymakers in allocating resources more efficiently.