Perioperative costs and charges of prostate brachytherapy and prostatectomy.
OBJECTIVE
To compare the costs and charges incurred for transrectal ultrasound-guided brachytherapy (USBT) and radical prostatectomy (RP) at a single institution.


METHODS
From February 1998 to March 1999, 66 consecutive patients underwent potentially curative therapy for clinically localized prostate cancer. Thirty-seven were treated by USBT using palladium-103 brachytherapy and 29 by RP. Hospital costs and charges and professional fees were obtained for a 2-month period beginning 1 month before RP or USBT and compared between the two procedures.


RESULTS
The mean total charges for USBT ($26,320) and RP ($22,660) were not significantly different. Compared with RP, USBT incurred significantly lower operating room time cost ($628 for USBT versus $2093 for RP, P <0.05). The average cost of seeds for USBT was $6184, which resulted in higher technical costs for USBT than for RP ($12,209 versus $7746, P <0.05). This was offset by lower professional fees for USBT ($7575 versus $9531). The ratio of charge to cost was lower for USBT than for RP (2.2 versus 3.0).


CONCLUSIONS
The total charges associated with brachytherapy appear similar to those associated with RP, although RP had relatively lower technical costs. Without a clear cost advantage of USBT over RP, the choice of therapy should continue to be primarily influenced by tumor characteristics, treatment efficacy, and patient preference.
Makhlouf
Antoine A
AA
Department of Urology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
Boyd
James C
JC
Chapman
Terrence N
TN
Theodorescu
Dan
D
D000230:Adenocarcinoma / Q000191:economics / Q000532:radiotherapy* / Q000601:surgery*; D001918:Brachytherapy / Q000191:economics*; D005249:Fees and Charges / Q000706:statistics & numerical data; D005251:Fees, Medical; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017722:Hospital Charges / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010165:Palladium / Q000627:therapeutic use; D011468:Prostatectomy / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics / Q000532:radiotherapy* / Q000601:surgery*; D018787:Radiation Oncology / Q000191:economics; D011868:Radioisotopes / Q000627:therapeutic use; D016896:Treatment Outcome
D011868:Radioisotopes; D010165:Palladium