Costs in different states of prostate cancer

Abstract

Objectives. 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.

Acknowledgments

This work was supported by the Cancer Society of Finland and GlaxoSmithKline Oy, Finland. The study sponsors were not involved in the study design, or the collection, analysis and interpretation of data nor were they involved in the writing of the manuscript; or in the decision to submit the manuscript for publication. All authors participated in the design of the study, data collection and drafting of the manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.