Real-World Economic Outcomes of Patients with Localized Prostate Cancer Treated with External Beam Radiation Therapy or Radical Prostatectomy.

IF 2.5 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research Pub Date : 2026-07-29 eCollection Date: 2026-01-01 DOI:10.36469/001c.163569

Lawrence Karsh, Shawn Du, Jinghua He, Neal Shore, Kruti Joshi

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引用次数: 0

Abstract

Background: External beam radiation therapy (EBRT) and radical prostatectomy (RP) are definitive options for patients with localized or locally advanced prostate cancer (LPC). Limited evidence exists on the post-treatment economic burden in these patients.

Objective: This real-world analysis investigated healthcare costs among Medicare beneficiaries with LPC who received EBRT or RP as initial definitive treatment.

Methods: This is a retrospective, longitudinal cohort study using Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Included were Medicare Fee-For-Service beneficiaries newly diagnosed with LPC at the age of ≥65 years during 2012-2019 and received either EBRT or RP as an initial definitive therapy. After the initial therapy, all-cause and prostate cancer-related costs were summarized and stratified by the earliest observed definitive therapy (RP vs EBRT) and the National Comprehensive Cancer Network risk classification (low/intermediate-risk [LIR-LPC] vs high-risk [HR-LPC]).

Results: Of the 17 066 LPC patients treated with EBRT, 60% (N =10 321) had LIR-LPC and 40% (N = 6745) had HR-LPC. During the follow-up, the mean per-person-per-year all-cause cost was $9837 h i g h e r i n t h e H R - L P C c o h o r t t h a n t h e L I R - L P C c o h o r t ($ 34 441 vs $24 604; P < .0001). Of the 9479 patients treated with RP, 43% (N = 4120) had LIR-LPC and 57% (N = 5359) had HR-LPC. The mean per-person-per-year all-cause cost during follow-up was $6829 h i g h e r i n t h e H R - L P C c o h o r t t h a n t h e L I R - L P C c o h o r t ($ 23 820 vs $16 991; P < .0001). Across all cohorts, the largest all-cause healthcare cost category was outpatient, followed by inpatient and prescription drug.

Conclusions: This real-world study on healthcare costs in patients with LPC treated with EBRT or RP showed HR-LPC is associated with significant incremental economic burden relative to LIR-LPC. The findings highlight the current unmet need for more cost-effective treatment strategies for HR-LPC.

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外部放射治疗或根治性前列腺切除术治疗局限性前列腺癌患者的实际经济效果。

背景：外束放射治疗（EBRT）和根治性前列腺切除术（RP）是局限性或局部晚期前列腺癌（LPC）患者的最终选择。关于这些患者治疗后经济负担的证据有限。目的：这个现实世界的分析调查医疗保险受益人的医疗保健费用与LPC谁接受EBRT或RP作为最初的最终治疗。方法：这是一项回顾性、纵向队列研究，使用监测、流行病学和最终结果(SEER)-Medicare数据库。纳入了2012-2019年期间新诊断为LPC的年龄≥65岁的医疗保险服务收费受益人，并接受了EBRT或RP作为初始决定性治疗。初始治疗后，根据最早观察到的最终治疗（RP vs EBRT）和国家综合癌症网络风险分类（低/中危[lr - lpc] vs高危[HR-LPC]）对全因和前列腺癌相关费用进行总结和分层。结果：在接受EBRT治疗的17066例LPC患者中，60% （N =10 321）为LIR-LPC， 40% （N = 6745）为HR-LPC。在随访期间,平均每人每年全因成本是9837 h我g h e r n t h e h L P C r - C o h o r t t h n t h e L i L P C r - C o h o r t(34 vs 441 24 604;P 6829 h我g h e r n t h e h L P C r - C o h o r t t h n t h e L i L P C r - C o h o r t(23 vs 820 16 991;P结论:这个真实的研究在医疗成本LPC EBRT处理或RP患者显示HR-LPC与相对于LIR-LPC显著的增量经济负担。研究结果强调了目前对更具成本效益的HR-LPC治疗策略的需求尚未得到满足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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