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Economic analysis of active surveillance for localized prostate cancer

Authors
Kim, SI; Dall'Era, MA; Evans, CP
Citation
Current opinion in urology, 22(3):247-253, 2012
Journal Title
Current opinion in urology
ISSN
0963-06431473-6586
Abstract
PURPOSE OF REVIEW: Active surveillance is gaining wider acceptance in the urologic community as an effective treatment option for patients with low-risk prostate cancer. The purpose of this review is to analyze the economics of active surveillance in comparison with other therapies.



RECENT FINDINGS: Evaluating the economics of active surveillance in patients with low-risk prostate cancer is constrained by a prolonged natural history of disease. Recent cost model studies using hypothetical patients with low-risk prostate cancer showed that the estimated direct cost of active surveillance over long term was the lowest compared with direct costs of immediate treatment with radical prostatectomy, external beam radiation therapy, primary androgen deprivation therapy or brachytherapy. Active surveillance is associated with more quality-adjusted life years than immediate therapies with similar or lower lifetime costs. Physician reimbursement for active surveillance exceeded that from upfront radical prostatectomy after 3-5 years of follow-up and may be an important driving factor for physicians to practice active surveillance.



SUMMARY: Active surveillance appears to reduce prostate cancer healthcare expenditure by reducing the number of costly therapies. Results from clinical trials will allow the measurement of the true economic value of active surveillance in the future.
MeSH terms
Cost-Benefit AnalysisDisease ProgressionEarly Detection of Cancer/*economics*Health Care CostsHealth ExpendituresHumansInsurance, Health, ReimbursementMaleMass Screening/*economicsPatient SelectionPopulation SurveillancePredictive Value of TestsPrognosisProstatic Neoplasms/*diagnosis/*economics/*therapyQuality-Adjusted Life YearsRisk AssessmentRisk FactorsTime FactorsWatchful Waiting/*economics
DOI
10.1097/MOU.0b013e328351dd32
PMID
22388666
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Urology
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