title: Technological changes in the management of prostate cancer result in increased healthcare costs--a retrospective study in a defined Swedish population.
abstract: OBJECTIVE
  In two previous studies we calculated direct costs for men with prostate cancer who died in 1984-85 and 1992-93, respectively. We have now performed a third cost analysis to enable a longitudinal cost comparison. The aim was to calculate direct costs for the management of prostate cancer, describe the economic consequences of technological changes over time and estimate total direct costs for prostate cancer in Sweden.
  
  
  METHODS
  A total of 204 men in a defined population with a diagnosis of prostate cancer and who died in 1997-98 were included. Data on utilization of health services were extracted from clinical records from time of diagnosis to death from a university hospital and from one county hospital in the county of Ostergötland.
  
  
  RESULTS
  The average direct cost per patient has been nearly stable over time (1984-85: 143 000 SEK; 1992-93: 150 000 SEK; 1997-98: 146 000 SEK). The share of costs for drugs increased from 7% in 1992-93 to 17% in 1997-98. The total direct costs for prostate cancer in Sweden have increased over time (1994-85: 610 MSEK; 1992-93: 860 MSEK; 1997-98: 970 MSEK).
  
  
  CONCLUSIONS
  Two-thirds of the total cost is incurred by inpatient care. The share of the total costs for drugs is increasing due to increased use of gonadotrophin-releasing hormone analogues. Small changes in average direct costs per patient despite greater use of technology are explained by the fact that more prostate cancers are detected at the early stages.
authors.affiliation: Center for Medical Technology Assessment, Linköping University Hospital, Sweden. karin.sennfalt@ihs.liu.se
authors.forename: Karin
authors.initials: K
authors.lastname: Sennfält
authors.forename: Per
authors.initials: P
authors.lastname: Carlsson
authors.forename: Johan
authors.initials: J
authors.lastname: Thorfinn
authors.forename: Jessica
authors.initials: J
authors.lastname: Frisk
authors.forename: Martin
authors.initials: M
authors.lastname: Henriksson
authors.forename: Eberhard
authors.initials: E
authors.lastname: Varenhorst
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000191:economics; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006766:Hospitals, County; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013677:Medical Laboratory Science / Q000191:economics; D008875:Middle Aged; D011336:Probability; D011468:Prostatectomy / Q000191:economics; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D011878:Radiotherapy / Q000191:economics / Q000379:methods; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013548:Sweden