title: Challenges in generating costs and utilisation rates associated with castration-resistant prostate cancer.
abstract: BACKGROUND
  Prostate cancer (PCa), the most commonly diagnosed cancer among men in the United States and Europe, is an escalating resource allocation issue across healthcare systems in the Western world. The impact of skeletal-related events, associated with castration-resistant prostate cancer (CRPC), is considerable with many new therapies being sought to treat these events in a cost-effective manner.
  
  
  OBJECTIVE
  The aim of this paper is to provide insight into the level of constraints associated with devising cost frameworks for economic analysis of CRPC in the Irish healthcare setting.
  
  
  METHODS
  An informal questionnaire was devised to obtain estimates of utilisation to populate a decision tree model; existing parameters from the literature were also employed. Cost parameters included Irish reference costs, and a costs literature review was undertaken; a healthcare payer perspective was adopted. Pharmacy dosages used for modelling costs were calculated for an average 75 kg male.
  
  
  RESULTS
  The estimated average cost of care associated with adverse events in CRPC was €23,264. Approximately 40% of the costs of CRPC are attributed to skeletal-related events; therefore, reducing the number of skeletal-related events could significantly reduce the cost of care. In attempting to generate accurate and reliable cost parameters, this study highlights the challenges of conducting economic analysis in the Irish healthcare setting.
  
  
  CONCLUSIONS
  This study presents leading treatments and associated costs for CRPC patients in the Republic of Ireland (RoI), which are expected to steadily increase with demographic shifts. Further research is warranted in this area due to the limitations encountered in the study.
authors.affiliation: University of East Anglia, Norwich, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Bourke
authors.affiliation: University of Oxford, Oxford, UK; National University of Ireland, Galway.
authors.forename: Richéal Maria
authors.initials: RM
authors.lastname: Burns
authors.affiliation: National University of Ireland, Galway.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gaynor
keywords: costs; health economics; prostate cancer; skeletal-related adverse events