Cost Analysis of Treatment Methods for localized Prostate Cancer

While treatments for localized prostate cancer have been reported to provide comparable overall

and cancer-specific survival rates, their costs have not been rigorously compared. A study published by the National Institutes of Health recently took a first step in collecting and analyzing this data.

The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study enrolled men with localized prostate cancer from 2011-2012, and questionnaires were collected at 6,12,36, and 60 months after enrollment. The primary outcome of the study was a comparison of the patient-reported differences in the financial burden of being managed with active surveillance, radical prostatectomy, or external beam radiotherapy.

Fifteen percent of the patients reported large or very large burden of treatment costs within 6 months that declined to 3% by year 5. External beam radiotherapy was associated with greater financial burden than either active surveillance or radical prostatectomy at 1 year and 3 years. Radical prostatectomy and active surveillance had similar rates of financial burden at all reporting points.

Thus, external beam radiotherapy was associated with the highest financial burden to patients even when controlling for age, education, and income. Additional studies that directly measure out-of-pocket and indirect costs that account more thoroughly for baseline socioeconomic differences are warranted.