Long-term health care costs for patients with prostate cancer: a population-wide longitudinal study in New South Wales, Australia.
OBJECTIVE
Prostate cancer (PCa) is the most commonly diagnosed cancer in Australian males. There are limited data on the long-term health system costs associated with PCa. The aim of this study is to estimate long-term health care costs of PCa.


METHODS
We estimated the health system costs for a cohort of 1873 males diagnosed with PCa between 2000 and 2002, using linked medical, pharmaceutical and hospital data. Treatment was defined by an initial phase, measuring health care costs up to 6 months following diagnosis and a continuing phase (including metastatic treatment), measuring treatments to 9.5 years. Nonparametric models were used to calculate average health care costs by PCa risk groups at diagnosis (low to metastatic) and treatment pathways.


RESULTS
Health system costs increased with increasing PCa risk category, from $16 923 (low risk) to $39 101 (metastatic risk group). For men with initial localized risk, costs were $8 454 for the active surveillance treatment pathway, $9621 for external beam radiation therapy/brachytherapy, $19 210 for androgen deprivation therapy, $20 636 for radical prostatectomy, $21 161 for radical prostatectomy + external beam radiation therapy/brachytherapy, $21 388 for any of the treatments previously listed + androgen deprivation therapy, with an additional cost of $55 370 if metastatic treatment was undertaken.


CONCLUSIONS
Treatment costs are highest during two phases over the natural cycle of the disease, the initial diagnosis phase and the metastatic treatment phase. Both the initial phase costs and low-risk category costs are driven largely by the rates of radical prostatectomy. Our study provides comprehensive long-term estimates of PCa costs.
Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Paula
P
Cronin
Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Brent
B
Kirkbride
Cancer Council NSW, Sydney, New South Wales, Australia.
Albert
A
Bang
Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Bonny
B
Parkinson
Cancer Council NSW, Sydney, New South Wales, Australia.|Menzies Health Institute Queensland, Griffith University, Queensland, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.
David
D
Smith
Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Philip
P
Haywood
D001315:Australia; D015331:Cohort Studies; D018672:Community Health Planning; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011471:Prostatic Neoplasms / Q000191:economics* / Q000473:pathology
cancer treatment; costs; prostate cancer