Initial Treatment Costs of Organ‐confined Prostate Cancer: A General Perspective

Kommu, Sashi S.; Eden, Christopher; Luscombe, Christopher J.; Golash, Anurag; Persad, Rajendra

doi:10.1111/j.1464-410x.2010.09885.x

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…There has been a steady rise in technological refinements in surgery (laparoscopic or robot assisted) and radiotherapy (intensity modulated radiotherapy, brachytherapy, stereo-tactic radiotherapy) with varying degrees of success in reducing morbidity of treatment [2,3]. All have led to rising costs [4].…”

Section: Introductionmentioning

confidence: 99%

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

et al. 2016

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“…Despite the similar proven efficacy in terms of overall survival [ 7 ], these treatments differ substantially in their side effects pattern [ 8 – 11 ]. With so many different alternatives, health economics may contribute with relevant information for decision-making on treatment for localized prostate cancer [ 12 ], and there has been an increasing number of economic evaluations worldwide: comparing surgery versus radiotherapy [ 13 , 14 ], different variations of prostatectomy [ 13 , 15 – 17 ] or radiotherapy [ 13 , 14 , 18 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review

Becerra

Ávila

Jiménez

et al. 2016

BMC Health Serv Res

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BackgroundOur objective was to assess the efficiency of treatments in patients with localized prostate cancer, by synthesizing available evidence from European economic evaluations through systematic review.MethodsArticles published 2000–2015 were searched in MEDLINE, EMBASE and NHS EED (Prospero protocol CRD42015022063). Two authors independently selected studies for inclusion and extracted the data. A third reviewer resolved discrepancies. We included European economic evaluations or cost comparison studies, of any modality of surgery or radiotherapy treatments, regardless the comparator/s. Drummond’s Checklist was used for quality assessment.ResultsAfter reviewing 8,789 titles, 13 European eligible studies were included: eight cost-utility, two cost-effectiveness, one cost-minimization, and two cost-comparison analyses. Of them, five compared interventions with expectant management, four contrasted robotic with non robotic-assisted surgery, three assessed new modalities of radiotherapy, and three compared radical prostatectomy with brachytherapy. All but two studies scored ≥8 in the quality checklist. Considering scenario and comparator, three interventions were qualified as dominant strategies (active surveillance, robotic-assisted surgery and IMRT), and six were cost-effective (radical prostatectomy, robotic-assisted surgery, IMRT, proton therapy, brachytherapy, and 3DCRT). However, QALY gains in most of them were small. For interventions considered as dominant strategies, QALY gain was 0.013 for active surveillance over radical prostatectomy; and 0.007 for robotic-assisted over non-robotic techniques. The highest QALY gains were 0.57–0.86 for radical prostatectomy vs watchful waiting, and 0.72 for brachytherapy vs conventional radiotherapy.ConclusionsCurrently, relevant treatment alternatives for localized prostate cancer are scarcely evaluated in Europe. Very limited available evidence supports the cost-effectiveness of radical prostatectomy over watchful waiting, brachytherapy over radical prostatectomy, and new treatment modalities over traditional procedures. Relevant disparities were detected among studies, mainly based on effectiveness. These apparently contradictory results may be reflecting the difficulty of interpreting small differences between treatments regarding QALY gains.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1781-z) contains supplementary material, which is available to authorized users.

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“…It has been suggested that different approaches are associated with variations in post-operative recovery and length-of stay (LOS) [16]. These developments might be expected to have impacted on LOS, but population-level data is limited.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting hospital length-of-stay after radical prostatectomy: a population-based study

Kelly

Sharp

Dwane

et al. 2013

BMC Health Serv Res

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BackgroundRadical prostatectomy (RP) is a leading treatment option for localised prostate cancer. Although hospital in-patient stays accounts for much of the costs of treatment, little is known about population-level trends in length-of-stay (LOS). We investigated factors predicting hospital LOS and readmissions in men who had RP following prostate cancer.MethodsIncident prostate cancers (ICD-O3: C61), diagnosed January 2002-December 2008 in men < 70 years, were identified from the Irish Cancer Registry, and linked to public hospital episodes. For those who had RP (ICD-9 CM procedure codes 60.3, 60.4, 60.5, 60.62) the associated hospital episode was identified. LOS was calculated as the number of days from date of admission to date of discharge. Patient-, tumour-, and health service-related factors predicting longer LOS (upper quartile, >9 days) were investigated using logistic regression. Patterns in day-case and in-patient readmissions within 28 days of discharge following RP were explored.ResultsOver the study period 9096 prostate cancers were diagnosed in men under 70, 26.5% of whom had RP by end of follow-up 31/12/2009. Two of eight public hospitals and eight of forty surgeons carried out 50% of all public-service RPs. Median LOS was 8 days (10th-90th percentile = 6-13 days) and fell significantly over time (2002, 9 days; 2008, 7 days; p < 0.001). In adjusted analyses men who were not married (OR = 1.71, 95% CI 1.25-2.34), had co-morbidities (OR = 1.64, 95% CI 1.25-2.16) or stage III-IV cancer (OR = 2.19, 95% CI 1.44-3.34) were significantly more likely to have prolonged LOS. Those treated in higher volume hospitals (annual median >49 RPs) or by higher volume surgeons (annual median >17 RPs) were significantly less likely to have prolonged LOS (OR = 0.34, 95% CI 0.26-0.45; OR = 0.55, 95% CI 0.42-0.71 respectively).ConclusionMedian LOS after RP decreased between 2002 and 2008 in Ireland but it remains higher than in both England and the US. Although volumes of RPs conducted in Ireland are low, there is considerable variation between hospitals and surgeons. Hospital and surgeon volume were strong predictors of shorter LOS, after adjusting for other variables. These factors point to a need for a comprehensive review of prostate cancer service provision.

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Initial Treatment Costs of Organ‐confined Prostate Cancer: A General Perspective

Abstract: REFERENCES

Cited by 7 publications

References 16 publications

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

Economic evaluation of treatments for patients with localized prostate cancer in Europe: a systematic review

Factors predicting hospital length-of-stay after radical prostatectomy: a population-based study

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