[Treatment costs of localized prostate cancer in Germany : Economic results from the HAROW observational study].
BACKGROUND
Prostate cancer (PCa) is the most common cancer in men. For medical treatment of PCa, a number of therapies are available. The economic consequences associated with these individual treatment options in routine care in Germany are unclear so far.


METHODS
The present analysis was based on the Germany-wide HAROW observational study, which was conducted from 2008-2013. During this study, all participating physicians and involved patients reported and documented individual health care resource consumption. These data were evaluated in monetary terms stratified by treatment regime (hormone therapy, HT; active surveillance, AS; radiotherapy, RT; radical prostatectomy, RP; watchful waiting, WW).


RESULTS
Overall, the data of 2672 patients were available for analysis. Based on the observational study design, the included patient groups were heterogeneous in their baseline characteristics. The annual total costs from the societal perspective were the largest for patient undergoing RP (9254 €; 95 % CI 8353-10,154), mainly driven by the costs for the initial hospital stay for surgery. HT, AS, RT, and WW seem to be comparable in terms of direct costs, ranging from 805 € (95 % CI 154-1455) for WW up to 1115 € (95 % CI 826-1405) for RT. The highest indirect costs were observed for patients receiving RT (3928 €; 95 % CI 0-10,675), which can be justified by the frequent incapacity to work in this patient group.


CONCLUSIONS
The treatment of prostate cancer can lead to significant economic follow-up costs which vary greatly depending on the type of treatment. The analysis indicates a need for the implementation of a long-term health economic study in the future, which will be more suitable to show treatment-specific differences in the temporal occurrence of costs.
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charite - Universitätsmedizin, Luisenstr. 57, 10117, Berlin, Deutschland. thomas.reinhold@charite.de.
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Reinhold
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charite - Universitätsmedizin, Luisenstr. 57, 10117, Berlin, Deutschland.
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Dornquast
Klinik für Urologie, onkologische Urologie und Kinderurologie, Krankenhaus Düren gem. GmbH, Düren, Deutschland.
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Börgermann
Stiftung Männergesundheit, Berlin, Deutschland.
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Weißbach
D000368:Aged; D017281:Cost of Illness; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D020249:Hormone Replacement Therapy / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011468:Prostatectomy / Q000191:economics; D011471:Prostatic Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D011878:Radiotherapy / Q000191:economics; D012307:Risk Factors; D057832:Watchful Waiting / Q000191:economics
Cost-analysis; Costs, direct; Health services research; Indirect costs; Prostate cancer