Initial Savings May Hide True Cost of Prostate Cancer Care
Posted Aug 23 2010 9:00am
Some treatments might be less costly short term, but more expensive over time, study finds
By Robert Preidt
Monday, August 23, 2010
MONDAY, Aug. 23 (HealthDay News) -- The initial treatment given to prostate cancer patients has a major impact on short- and long-term costs of care, a new study has found.
For example, while some may opt for an initial treatment that is less expensive in the short-term, the long-term costs of that treatment may actually be higher, the study authors explained.
Treatments options for early-stage prostate cancer include surgery, radiation therapy, hormonal treatment, watchful waiting, or combinations of those methods. Decisions about which treatment to use are based on a variety of factors, including cost, according to background information in the study, published online Aug. 23 in the journal Cancer.
In the study, U.S. researchers analyzed data from 13,769 prostate cancer patients, aged 66 and older, who were diagnosed in 2000 and followed-up for a period of five years. The data came from the Surveillance, Epidemiology and End Results (SEER)-Medicare database.
The men were divided into groups based on the treatment they received during the first nine months after being diagnosed with prostate cancer: watchful waiting, radiation, hormonal therapy, hormonal therapy plus radiation, and surgery. The men in the surgery group may also have received hormones and/or radiation therapy.
For most of these cases, treatment costs were highest in the first year and then declined sharply and remained steady over the next several years. According to the report, watchful waiting had the lowest initial ($4,270) and five-year total costs ($9,130), and hormonal therapy had the second lowest initial cost but the highest five-year total cost ($26,896).
The highest initial treatment costs were observed among those receiving hormonal therapy plus radiation ($17,474), and those undergoing surgery ($15,197), the investigators noted.
Over five years, total costs for hormonal therapy plus radiation were $25,097, and $19,214 for surgery.
When the researchers took into account that costs of treatment in the last 12 months of life are different than other treatment years and excluded the costs for that year, they found that total costs were highest for hormonal therapy plus radiation ($23,488) and hormonal therapy only ($23,199).
"This demonstrates that treatments that may be less expensive in the short term may have higher long-term costs," study leader Claire Snyder, of the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health in Baltimore, said in a journal news release.