학술논문
Comparison of the medical costs between active surveillance and other treatments for early prostate cancer in Japan using data from the PRIAS-JAPAN study.
Document Type
Academic Journal
Author
Kato T; Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.; Yokomizo A; Department of Urology, Harasanshin Hospital, Fukuoka, Japan.; Matsumoto R; Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.; Tohi Y; Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.; Miyakawa J; Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Mitsuzuka K; Department of Urology, Tohoku University School of Medicine, Sendai, Japan.; Sasaki H; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.; Inokuchi J; Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.; Matsumura M; Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.; Sakamoto S; Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.; Kinoshita H; Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, Hirakata, Japan.; Fukuhara H; Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.; Kamiya N; Department of Urology, Toho University Sakura Medical Center, Sakura, Japan.; Kimura R; Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Japan.; Nitta M; Department of Urology, Tokai University School of Medicine, Hiratsuka, Japan.; Okuno H; Department of Urology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.; Akakura K; Department of Urology, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan.; Kakehi Y; Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.; Sugimoto M; Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.
Source
Publisher: Blackwell Science Asia Country of Publication: Australia NLM ID: 9440237 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1442-2042 (Electronic) Linking ISSN: 09198172 NLM ISO Abbreviation: Int J Urol Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: To compare the medical costs of active surveillance with those of robot-assisted laparoscopic prostatectomy, brachytherapy, intensity-modulated radiation therapy, and hormone therapy for low-risk prostate cancer.
Methods: The costs of protocol biopsies performed in the first year of surveillance (between January 2010 and June 2020) and those of brachytherapy and radiation therapy performed between May 2019 and June 2020 at the Kagawa University Hospital were analyzed. Hormone therapy costs were assumed to be the costs of luteinizing hormone-releasing hormone analogs for over 5 years. Active surveillance-eligible patients were defined based on the following: age <74 years, ≤T2, Gleason score ≤6, prostate-specific antigen level ≤10 ng/ml, and 1-2 positive cores. We estimated the total number of active surveillance-eligible patients in Japan based on the Japan Study Group of Prostate Cancer (J-CAP) study and the 2017 cancer statistical data. We then calculated the 5-year treatment costs of active surveillance-eligible patients using the J-CAP and PRIAS-JAPAN study data.
Results: In 2017, number of active surveillance-eligible patients in Japan was estimated to be 2808. The 5-year total costs of surveillance, prostatectomy, brachytherapy, radiation therapy, and hormone therapy were 1.65, 14.0, 4.61, 4.04, and 5.87 million United States dollar (USD), respectively. If 50% and 100% of the patients in each treatment group had opted for active surveillance as the initial treatment, the total treatment cost would have been reduced by USD 6.89 million (JPY 889 million) and USD 13.8 million (JPY 1.78 billion), respectively.
Conclusion: Expanding active surveillance to eligible patients with prostate cancer helps save medical costs.
(© 2022 The Japanese Urological Association.)
Methods: The costs of protocol biopsies performed in the first year of surveillance (between January 2010 and June 2020) and those of brachytherapy and radiation therapy performed between May 2019 and June 2020 at the Kagawa University Hospital were analyzed. Hormone therapy costs were assumed to be the costs of luteinizing hormone-releasing hormone analogs for over 5 years. Active surveillance-eligible patients were defined based on the following: age <74 years, ≤T2, Gleason score ≤6, prostate-specific antigen level ≤10 ng/ml, and 1-2 positive cores. We estimated the total number of active surveillance-eligible patients in Japan based on the Japan Study Group of Prostate Cancer (J-CAP) study and the 2017 cancer statistical data. We then calculated the 5-year treatment costs of active surveillance-eligible patients using the J-CAP and PRIAS-JAPAN study data.
Results: In 2017, number of active surveillance-eligible patients in Japan was estimated to be 2808. The 5-year total costs of surveillance, prostatectomy, brachytherapy, radiation therapy, and hormone therapy were 1.65, 14.0, 4.61, 4.04, and 5.87 million United States dollar (USD), respectively. If 50% and 100% of the patients in each treatment group had opted for active surveillance as the initial treatment, the total treatment cost would have been reduced by USD 6.89 million (JPY 889 million) and USD 13.8 million (JPY 1.78 billion), respectively.
Conclusion: Expanding active surveillance to eligible patients with prostate cancer helps save medical costs.
(© 2022 The Japanese Urological Association.)