title: Costs in different states of prostate cancer.
abstract: OBJECTIVE
  This cross-sectional study assesses resource use and costs in different states of prostate cancer (PCa) in a real-life setting. Costs were estimated as incremental costs due to cancer for a six-month period and they included direct medical costs, productivity costs and costs of informal care.
  
  
  METHODS
  Resource use and cost data, irrespective of who the payer was, were retrieved from the registries for 611 PCa patients in the Helsinki area in Finland. In addition, patients answered background questions concerning informal care, work capacity and educational status. Patients were divided into four mutually exclusive groups based on disease state and time from diagnosis: primary (local disease, first six months after diagnosis; n = 47), rehabilitation (local disease, 0.5-1.5 years after diagnosis or recurrence; n = 158), remission (local disease, more than 1.5 years after diagnosis; n = 317) and metastatic (after detection of metastases; n = 89).
  
  
  RESULTS
  Costs differed markedly between the states of disease. Mean direct health care costs for the six-month periods were: primary treatment state € 2750, rehabilitation state € 1143, remission state € 760 and metastatic state € 7423. Productivity costs were also highest (€ 4277) in the metastatic state. Overall, the average share of indirect costs was around one third of the total costs. However, when including informal care, their combined share of the total costs increased to around half or more.
  
  
  CONCLUSIONS
  The results provided state-specific estimates of the direct health care and indirect costs of PCa in Finland. The treatment of metastatic disease is significantly more costly than treatment of early stage PCa. Although direct medical costs were higher compared to productivity costs, they should be taken into consideration when evaluating the costs of PCa.
authors.affiliation: a University of Helsinki, Department of Public Health , Helsinki , Finland.|b Teva Pharmaceuticals Europe , Amsterdam , The Netherlands.
authors.forename: Saku
authors.initials: S
authors.lastname: Torvinen
authors.affiliation: a University of Helsinki, Department of Public Health , Helsinki , Finland.|c GlaxoSmithKline , Espoo , Finland.
authors.forename: Niilo
authors.initials: N
authors.lastname: Färkkilä
authors.affiliation: d University of Eastern Finland, Kuopio, Finland and Hospital District of Helsinki and Uusimaa , Helsinki , Finland.
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.affiliation: a University of Helsinki, Department of Public Health , Helsinki , Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.affiliation: e Department of Oncology , Helsinki University Central Hospital, Helsinki, Finland and University of Helsinki , Helsinki , Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Saarto
authors.affiliation: f Department of Urology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004180:Direct Service Costs; D004526:Efficiency; D005387:Finland; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011471:Prostatic Neoplasms / Q000191:economics* / Q000473:pathology