• 作者：Virginia Becerra Bachino^a ; Francesc Cots^b ; ^c ; Ferran Guedea^d ; Joan Pera^d ; Ana Boladeras^d ; Ferran Aguiló ; ^e ; José ; Francisco Suá ; rez^e ; Pedro Gallo^c ; ^f ; Lluis Murgui^f ; ^g ; À ; ngels Pont^a ; Oriol Cunillera^a ; Yolanda Pardo^a ; Montserrat Ferrer^a ; ^c ; ^h ; ^{mferrer@imim.es} ; Grupo Multicé ; ntrico Españ ; ol de C&aacute ; ncer de Pró ; stata Organoconfinado^&loz ;
• 关键词：C&aacute ; ncer de pró ; stata ; Costes ; Prostatectomí ; a ; Braquiterapia ; Radioterapia
• 刊名：Gaceta Sanitaria
• 出版年：2011
• 期刊代码：pca166_02139111
• 类别：med
• 出版时间：January-February 2011
• 卷：25
• 期：1
• 页码：35-43
• 文件大小：166 K

Objective

To compare the initial costs of the three most established treatments for clinically localized prostate cancer according to risk, age and comorbidity groups, from the healthcare provider's perspective.

Methods

We carried out a cost comparison study in a sample of patients consecutively recruited between 2003 and 2005 from a functional unit for prostate cancer treatment in Catalonia (Spain). The use of services up to 6 months after the treatment start date was obtained from hospital databases and direct costs were estimated by micro-cost calculation. Information on the clinical characteristics of patients and treatments was collected prospectively. Costs were compared by using nonparametric tests comparing medians (Kruskall-Wallis) and a semi-logarithmic multiple regression model.

Results

Among the 398 patients included, the cost difference among treatments was statistically significant: medians were 鈧?,229.10, 鈧?,369.00 and 鈧?,265.60, respectively, for the groups of patients treated with external 3D conformal radiotherapy, brachytherapy and radical retropublic prostatectomy, (p < 0.001). In the multivariate analysis (adjusted R² = 0.8), the average costs of brachytherapy and external radiotherapy were significantly lower than that of prostatectomy (coefficient -0.212 and -0.729, respectively).

Conclusions

Radical prostatectomy proved to be the most expensive treatment option. Overall, the estimated costs in our study were lower than those published elsewhere. Most of the costs were explained by the therapeutic option and neither comorbidity nor risk groups showed an effect on total costs independent of treatment.