Cost comparison of curative therapies for localized prostate cancer in Japan: a single-institution experience.
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.
Satoh
Takefumi
T
Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, 228-8555, Japan. tsatoh@kitasato-u.ac.jp
Ishiyama
Hiromichi
H
Matsumoto
Kazumasa
K
Tabata
Ken-ichi
K
Kitano
Masashi
M
Iwamura
Masatsugu
M
Kimura
Masaki
M
Minamida
Satoru
S
Yamashita
Hideyuki
H
Matsuda
Daisuke
D
Kotani
Shouko
S
Niibe
Yuzuru
Y
Uemae
Mineko
M
Hayakawa
Kazushige
K
Baba
Shiro
S
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
D007457:Iodine Radioisotopes