title: [Cost comparison of three treatments for localized prostate cancer in Spain: radical prostatectomy, prostate brachytherapy and external 3D conformal radiotherapy].
abstract: OBJECTIVE
  To compare the initial costs of the three most established treatments for clinically localized prostate cancer according to risk, age and comorbidity groups, from the healthcare provider's perspective.
  
  
  METHODS
  We carried out a cost comparison study in a sample of patients consecutively recruited between 2003 and 2005 from a functional unit for prostate cancer treatment in Catalonia (Spain). The use of services up to 6 months after the treatment start date was obtained from hospital databases and direct costs were estimated by micro-cost calculation. Information on the clinical characteristics of patients and treatments was collected prospectively. Costs were compared by using nonparametric tests comparing medians (Kruskall-Wallis) and a semi-logarithmic multiple regression model.
  
  
  RESULTS
  Among the 398 patients included, the cost difference among treatments was statistically significant: medians were € 3,229.10, € 5,369.00 and € 6,265.60, respectively, for the groups of patients treated with external 3D conformal radiotherapy, brachytherapy and radical retropublic prostatectomy, (p<0.001). In the multivariate analysis (adjusted R(2)=0.8), the average costs of brachytherapy and external radiotherapy were significantly lower than that of prostatectomy (coefficient -0.212 and -0.729, respectively).
  
  
  CONCLUSIONS
  Radical prostatectomy proved to be the most expensive treatment option. Overall, the estimated costs in our study were lower than those published elsewhere. Most of the costs were explained by the therapeutic option and neither comorbidity nor risk groups showed an effect on total costs independent of treatment.
authors.affiliation: Unidad de Investigación en Servicios Sanitarios, IMIM-Hospital del Mar, Barcelona, España.
authors.forename: Virginia
authors.initials: V
authors.lastname: Becerra Bachino
authors.forename: Francesc
authors.initials: F
authors.lastname: Cots
authors.forename: Ferran
authors.initials: F
authors.lastname: Guedea
authors.forename: Joan
authors.initials: J
authors.lastname: Pera
authors.forename: Ana
authors.initials: A
authors.lastname: Boladeras
authors.forename: Ferran
authors.initials: F
authors.lastname: Aguiló
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Suárez
authors.forename: Pedro
authors.initials: P
authors.lastname: Gallo
authors.forename: Lluis
authors.initials: L
authors.lastname: Murgui
authors.forename: Angels
authors.initials: A
authors.lastname: Pont
authors.forename: Oriol
authors.initials: O
authors.lastname: Cunillera
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Pardo
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ferrer
mesh_terms: D000230:Adenocarcinoma / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D001918:Brachytherapy / Q000191:economics*; D003365:Costs and Cost Analysis; D004180:Direct Service Costs / Q000706:statistics & numerical data; D006801:Humans; D007457:Iodine Radioisotopes / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery; D019275:Radiopharmaceuticals / Q000191:economics / Q000627:therapeutic use; D020266:Radiotherapy, Conformal / Q000191:economics*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals