title: Cost comparison of curative therapies for localized prostate cancer in Japan: a single-institution experience.
abstract: OBJECTIVE
  In addition to open surgery, curative therapies for prostate cancer now include endoscopic surgery and radiation therapies. Because of the expansion and subdivision of treatment methods for prostate cancer, the medical fee point schedule in Japan was revised in fiscal year 2006. We examined changes in medical income and expenditure after this revision of the medical fee system.
  
  
  METHODS
  We studied income and expenditure, after institution of the new medical fee schedule, for the five types of therapies for prostate cancer performed at our hospital: two surgical therapies (radical retropubic prostatectomy and laparoscopic prostatectomy) and three radiation therapies (three-dimensional conformal radiation therapy, (192)Ir high-dose-rate brachytherapy, and (125)I low-dose-rate brachytherapy).
  
  
  RESULTS
  Low-dose-rate brachytherapy was found to be associated with a profit of yen199 per patient. Laparoscopic prostatectomy, a highly advanced medical treatment that the fee revision changed from a partially insured to an insured procedure, yielded a profit of yen75,672 per patient. However, high-dose-rate brachytherapy was associated with a loss of yen654,016 per patient.
  
  
  CONCLUSIONS
  Given the loss in hospital income per patient undergoing high-dose-rate brachytherapy, the medical fee point system for this procedure should be reassessed.
authors: Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, 228-8555, Japan. tsatoh@kitasato-u.ac.jp
authors: Takefumi
authors: T
authors: Satoh
authors: Hiromichi
authors: H
authors: Ishiyama
authors: Kazumasa
authors: K
authors: Matsumoto
authors: Ken-ichi
authors: K
authors: Tabata
authors: Masashi
authors: M
authors: Kitano
authors: Masatsugu
authors: M
authors: Iwamura
authors: Masaki
authors: M
authors: Kimura
authors: Satoru
authors: S
authors: Minamida
authors: Hideyuki
authors: H
authors: Yamashita
authors: Daisuke
authors: D
authors: Matsuda
authors: Shouko
authors: S
authors: Kotani
authors: Yuzuru
authors: Y
authors: Niibe
authors: Mineko
authors: M
authors: Uemae
authors: Kazushige
authors: K
authors: Hayakawa
authors: Shiro
authors: S
authors: Baba
mesh_terms: D001918:Brachytherapy / Q000191:economics* / Q000379:methods; D003365:Costs and Cost Analysis / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007457:Iodine Radioisotopes / Q000191:economics / Q000627:therapeutic use; D007564:Japan; D008297:Male; D011468:Prostatectomy / Q000191:economics* / Q000379:methods; D011471:Prostatic Neoplasms / Q000191:economics* / Q000628:therapy*; D020266:Radiotherapy, Conformal / Q000191:economics* / Q000379:methods
chemical_list: D007457:Iodine Radioisotopes