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Cost study of the clinical management of prostate cancer in France: results on the basis of population-based data

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Abstract

Prostate cancer is an important disease in terms of economic implications because of its increasing incidence and health care costs. We assessed the direct costs of the clinical management of prostate cancer in France. A retrospective study based on population-based data was carried out. Eight hundred and seventy-nine cases of prostate cancer diagnosed in five departments were included in a 5-year follow-up study. The economic analysis adopted the health-care payer’s perspective and took into account only the direct costs. The mean cost of managing patients was estimated at €12,731. It is composed of 49 to 82% of initial treatments according to the therapeutic strategy. The follow-up constituted between 3 and 11%, the costs of treatments for side effects between 1 and 3% and the travel cost between 3 and 7%. Cumulative total costs over 5 years for each treatment group showed variation in costs. Costs were highest for patients who were treated with external-beam radiotherapy and lowest for those with watchful waiting. The cost burden of prostate cancer is high and varies according to the treatment type. This study yielded a cost analysis of the different management practices of patients with prostate cancer.

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References

  1. Ruchlin, H.S., Pellissier, J.M.: An economic overview of prostate carcinoma. Cancer 92, 2796–2810 (2001)

    Article  PubMed  CAS  Google Scholar 

  2. Parkin, D.M., Bray, F., Ferlay, J., Pisani, P.: Global cancer statistics, 2002. CA. Cancer J. Clin. 55, 74–108 (2005)

    Article  PubMed  Google Scholar 

  3. Ferlay, J., Autier, P., Boniol, M., Heanue, M., Colombet, M., Boyle, P.: Estimates of the cancer incidence and mortality in Europe in 2006. Ann. Oncol. 18, 581–592 (2007)

    Article  PubMed  CAS  Google Scholar 

  4. Institut de Veille Sanitaire: Estimation cancer, Incidence—Mortalité, 1980–2005. http://www.invs.sante.fr/surveillance/cancers/estimations_cancers (2009). Accessed 23 January 2009

  5. Aus, G., Abbou, C.C., Bolla, M., Heidenreich, A., Schmid, H.P., van Poppel, H., Wolff, J., Zattoni, F.: EAU guidelines on prostate cancer. Eur. Urol. 48, 546–551 (2005)

    Article  PubMed  CAS  Google Scholar 

  6. Samant, R.S., Dunscombe, P.B., Roberts, G.H.: A cost-outcome analysis of long-term adjuvant goserelin in addition to radiotherapy for locally advanced prostate cancer. Urol. Oncol. 21, 171–177 (2003)

    Article  PubMed  CAS  Google Scholar 

  7. Sennfält, K., Carlsson, P., Thorfinn, J., Frisk, J., Henriksson, M., Varenhorst, E.: Technological changes in the management of prostate cancer result in increased healthcare costs. A retrospective study in a defined Swedish population. Scand. J. Urol. Nephrol. 37, 226–231 (2003)

    Article  PubMed  Google Scholar 

  8. Grover, S.A., Zowall, H., Coupal, L., Krahn, M.D.: Prostate cancer: 12. The economic burden. Can. Med. Assoc. J. 160, 685–690 (1999)

    CAS  Google Scholar 

  9. Grover, S.A., Coupal, L., Zowall, H., Rajan, R., Trachtenberg, J., Elhilali, M., Chetner, M., Goldenberg, L.: The economic burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model. Can. Med. Assoc. J. 162, 987–992 (2000)

    CAS  Google Scholar 

  10. Molinier, L., Bauvin, E., Combescure, C., Castelli, C., Rebillard, X., Soulié, M., Daurès, J.P., Grosclaude, P.: Methodological considerations in cost of prostate cancer studies: a systematic review. Value Health 11, 878–885 (2008)

    Article  PubMed  Google Scholar 

  11. Soulié, M., Grosclaude, P., Villers, A., Menegoz, F., Schaffer, P., Mace-Lesec’h, J., Molinier, L., Sauvage-Machelard, M.: A population-based study on management of prostate cancer in four regions of France. Prostate Cancer Prostatic Dis. 4, 154–160 (2001)

    Article  PubMed  Google Scholar 

  12. Bauvin, E., Molinier, L., Dervaux, B., Soulié, M., Latorzeff, I., Bachaud, J.M., Villers, A., Elias, A., Grosclaude, P.: Cost and efficacy of treatment strategies in localized prostatic cancer: feasibility study in the general population. Prog. Urol. 13, 618–623 (2003)

    PubMed  Google Scholar 

  13. Lu-Yao, G.L., Yao, S.L.: Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet 349, 906–910 (1997)

    Article  PubMed  CAS  Google Scholar 

  14. Chirpaz, E., Colonna, M., Menegoz, F., Grosclaude, P., Schaffer, P., Arveux, P., Lesec’h, J.M., Exbrayat, C., Schaerer, R.: Incidence and mortality trends for prostate cancer in 5 French areas from 1982 to 1996. Int. J. Cancer 97, 372–376 (2002)

    Article  PubMed  CAS  Google Scholar 

  15. National Cancer Institute: Surveillance epidemiology and end results. http://seer.cancer.gov/faststats/sites.php?site=Prostate+Cancer&stat=Definitions (2008). Accessed 19 April 2008

  16. Jones, J., Hunter, D.: Consensus methods for medical and health services research. BMJ 311, 376–380 (1995)

    PubMed  CAS  Google Scholar 

  17. Agence Nationale d’Accréditation et d’Evaluation en Santé. Les traitements du cancer localisé de la prostate: synthèse. ANAES (2001)

  18. Fédération Nationale des Centres de Lutte Contre le Cancer, Association Française d’Urologie. Standards, options et recommandations pour la prise en charge des patients atteints de cancer de la prostate non métastatique. Document de travail, FNCLCC (2001)

  19. Detsky, A.S., Naglie, I.G.: A clinician’s guide to cost-effectiveness analysis. Ann. Intern. Med. 113, 147–154 (1990)

    PubMed  CAS  Google Scholar 

  20. Drummond, M.F., Sculpher, M.J., Torrance, G.W., O’Brien, B.J., Stoddart, G.L.: Methods for the Economic Evaluation of Health Care Programmes, 3rd edn. Oxford University Press, Oxford (2005)

    Google Scholar 

  21. The Comprehensive R Archive Network: The R Project for Statistical Computing. http://www.r-project.org (2009). Accessed 9 April 2009

  22. Remontet, L., Buemi, A., Velten, M., Jougla, E., Estève, J.: Evolution de l’incidence et de la mortalité par cancer en France de 1978 à 2000. Institut de Veille Sanitaire, Paris (2002)

    Google Scholar 

  23. Hernàn, M.A., Hernàndez-Diaz, S., Werler, M.M., Mitchell, A.A.: Causal knowledge as a prerequisite for confounding evaluation: An application to birth defects epidemiology. Am. J. Epidemiol. 155, 176–184 (2002)

    Article  PubMed  Google Scholar 

  24. Soulié, M., Beuzeboc, P., Cornud, F., Eschwege, P., Gaschignard, N., Grosclaude, P., Hennequin, C., Maingon, P., Molinié, V., Mongiat-artus, P., Moreau, J.L., Paparel, P., Péneau, M., Peyromaure, M., Ravery, V., Rébillard, X., Richaud, P., Salomon, L., Staerman, F., Villers, A.: Recommandations de l’association française d’urologie: cancer de la prostate. Prog. Urol. 17, 1159–1230 (2007)

    Article  PubMed  Google Scholar 

  25. Andriole, G.L., Grubb III, R.L., Buys, S.S., Chia, D., Church, T.R., Fouad, M.N., Gelmann, E.P., Kvale, P.A., Reding, D.J., Weissfeld, J.L., Yokochi, L.A., Crawford, E.D., O’Brien, B., Clapp, J.D., Rathmell, J.M., Riley, T.L., Hayes, R.B., Kramer, B.S., Izmirlian, G., Miller, A.B., Pinsky, P.F., Prorok, P.C., Gohagan, J.K., Berg, C.D., PLCO Project Team: Mortality results from a randomized prostate-cancer screening trial. N. Engl. J. Med. 360, 1310–1319 (2009)

    Article  PubMed  CAS  Google Scholar 

  26. Schröder, F.H., Hugosson, J., Roobol, M.J., Tammela, T.L., Ciatto, S., Nelen, V., Kwiatkowski, M., Lujan, M., Lilja, H., Zappa, M., Denis, L.J., Recker, F., Berenguer, A., Määttänen, L., Bangma, C.H., Aus, G., Villers, A., Rebillard, X., van der Kwast, T., Blijenberg, B.G., Moss, S.M., de Koning, H.J., Auvinen, A.: ERSPC Investigators.: Screening and prostate-cancer mortality in a randomized European study. N. Engl. J. Med. 360, 1320–1328 (2009)

    Article  PubMed  Google Scholar 

  27. Haillot, O., Villers, A., Soulié, M., Baron, J.C.: Dépistage du cancer de la prostate (IV). Approche économique: les coûts des tests de dépistage et des traitements. Prog. Urol. 8, 517–523 (1998)

    PubMed  CAS  Google Scholar 

  28. Neymark, N., Adriaenssen, I., Gorlia, T., Caleo, S., Bolla, M., Brochon, D.: Cost-effectiveness of the addition of early hormonal therapy in locally advanced prostate cancer: results decisively determined by the cut-off time-point chosen for the analysis. Eur. J. Cancer 37, 1768–1774 (2001)

    Article  PubMed  CAS  Google Scholar 

  29. Amalric, F.: Analyse économique des coûts du cancer en France. Institut National du Cancer, Boulogne-Billancourt (2007)

    Google Scholar 

  30. Buron, C., Le Vu, B., Cosset, J.M., Pommier, P., Peiffert, D., Delannes, M., Flam, T., Guerif, S., Salem, N., Chauveinc, L., Livartowski, A.: Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study. Int. J. Radiat. Oncol. Biol. Phys. 67, 812–822 (2007)

    Article  PubMed  Google Scholar 

  31. Bauvin, E., Soulié, M., Menegoz, F., Mace-Lesec’h, J., Buemi, A., Velten, M., Villers, A., Grosclaude, P.: Medical and non-medical determinants of prostate cancer management: a population-based study. Eur. J. Cancer 39, 2364–2371 (2003)

    Article  PubMed  CAS  Google Scholar 

  32. Max, W., Rice, D.P., Sung, H.Y., Michel, M., Breuer, W., Zhang, X.: The economic burden of prostate cancer, California, 1998. Cancer 94, 2906–2913 (2002)

    Article  PubMed  Google Scholar 

  33. Norlund, A., Alvegård, T., Lithman, T., Merlo, J., Noreen, D.: Prostate cancer. Prevalence-based healthcare costs. Scand. J. Urol. Nephrol. 37, 371–375 (2003)

    Article  PubMed  Google Scholar 

  34. Jayadevappa, R., Bloom, B.S., Chhatre, S., Fomberstein, K.M., Wein, A.J., Malkowicz, S.B.: Health related quality of life and direct medical care cost in newly diagnosed younger men with prostate cancer. J. Urol. 174, 1059–1064 (2005)

    Article  PubMed  Google Scholar 

  35. Penson, D.F., Chan, J.M., Urologic Diseases in America Project: Prostate cancer. J. Urol. 177, 2020–2029 (2007)

    Article  PubMed  Google Scholar 

  36. Wilson, L.S., Tesoro, R., Elkin, E.P., Sadetsky, N., Broering, J.M., Latini, D.M., DuChane, J., Mody, R.R., Carroll, P.R.: Cumulative cost pattern comparison of prostate cancer treatments. Cancer 109, 518–527 (2007)

    Article  PubMed  Google Scholar 

  37. Chamberlain, J., Melia, J., Moss, S., Brown, J.: The diagnosis, management, treatment and costs of prostate cancer in England and Wales. Health Technol. Assess. 1, 1–53 (1997)

    Google Scholar 

  38. Litwin, M.S., Pasta, D.J., Stoddard, M.L., Henning, J.M., Carroll, P.R.: Epidemiological trends and financial outcomes in radical prostatectomy among Medicare beneficiaries, 1991 to 1993. J. Urol. 160, 445–448 (1998). Erratum in: J. Urol. 160, 2164

    Article  PubMed  CAS  Google Scholar 

  39. Chang, S., Long, S.R., Kutikova, L., Bowman, L., Finley, D., Crown, W.H., Bennett, C.L.: Estimating the cost of cancer: results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000. J. Clin. Oncol. 22, 3524–3530 (2004)

    Article  PubMed  Google Scholar 

  40. Burkhardt, J.H., Litwin, M.S., Rose, C.M., Correa, R.J., Sunshine, J.H., Hogan, C., Hayman, J.A.: Comparing the costs of radiation therapy and radical prostatectomy for the initial treatment of early-stage prostate cancer. J. Clin. Oncol. 20, 2869–2875 (2002)

    Article  PubMed  Google Scholar 

  41. Grossfeld, G.D., Li, Y.P., Lubeck, D.P., Carroll, P.R.: Patterns of failure after primary local therapy for prostate cancer and rationale for secondary therapy. Urology 60, 57–63 (2002)

    Article  PubMed  Google Scholar 

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Acknowledgments

The funding for this study was provided by the Programme Hospitalier de Recherche Clinique 2002. The authors have no conflicts of interest that are directly relevant to the content of this manuscript. They gratefully acknowledge JP Ansieau, G Belot, D Brune, M Bolla, O Brun, A Clottes, JL Descotes, JM Grunenwald, S Guarnieri, D Jaqmin, GM Jung, I Latorzeff, S Mollier, P Salze, C Schoenahl, M Tenaillon, JP Wagner and Alexandra Andreescu for their assistance.

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Authors and Affiliations

  1. Faculté de Médecine, INSERM U558, Toulouse, France

    Laurent Molinier, Eric Bauvin, Michel Soulié & Pascale Grosclaude

  2. Département d’Information Médicale, Centre Hospitalier Universitaire, Hôtel-Dieu Saint-Jacques, 2 rue Viguerie, TSA 80035, 31059, Toulouse Cedex 9, France

    Laurent Molinier

  3. Laboratoire de Biostatistique, Institut Universitaire de Recherche Clinique, Montpellier, France

    Christel Castelli & Jean-Pierre Daurès

  4. Département Biostatistique Epidemiologie clinique Santé Publique et Information Médicale (BESPIM), Centre Hospitalier Universitaire, Nîmes, France

    Christel Castelli & Jean-Pierre Daurès

  5. Faculté de Médecine, Réseau Régional de Cancérologie de Midi-Pyrénées, Toulouse, France

    Eric Bauvin

  6. Service d’urologie, Clinique Beau-Soleil, Montpellier, France

    Xavier Rebillard

  7. Service de Chirurgie Urologique, Centre Hospitalier Universitaire, Toulouse, France

    Michel Soulié

  8. Registre des Cancers du Tarn, Albi, France

    Pascale Grosclaude

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  1. Laurent Molinier
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  2. Christel Castelli
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  7. Pascale Grosclaude
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Correspondence to Laurent Molinier.

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Molinier, L., Castelli, C., Bauvin, E. et al. Cost study of the clinical management of prostate cancer in France: results on the basis of population-based data. Eur J Health Econ 12, 363–371 (2011). https://doi.org/10.1007/s10198-010-0250-6

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  • DOI: https://doi.org/10.1007/s10198-010-0250-6

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