Cost of care in localized prostate cancer varies widely with treatments and phases of care. This study aimed to evaluate the total direct medical costs and phase-specific costs associated with two minimally invasive treatment options (conservative management and cryotherapy) from Medicare perspective in patients with localized prostate cancer.Methods:
The Surveillance, Epidemiology, and End Result program linked to the Medicare data from 2000 to 2014 was utilized. The total direct medical cost and phase-specific costs were calculated from Medicare's perspective. Phase-specific costs were divided into three phases: initial, continuing and terminal phases. Cost was presented at 2014 US dollar values. Nonparametric bootstrapping and generalized linear models with gamma distribution and log link function were performed.Key findings:
The average total direct cost of cancer care in the conservative management and cryotherapy cohort was approximately $13 664 and $14 312 respectively. Compared to the cryotherapy cohort, patients in the conservative management cohort had significantly lower cost in the initial ($3708 versus $4780), continuing ($1504 versus $2253) and the terminal phases of care ($13 387 versus $15 532). Results from the generalized linear model showed that conservative management incurred significantly lower costs across all phases of care compared with cryotherapy after adjusting for the covariates.Conclusions:
This study shows the importance of conservative management as a cost-saving strategy for patients with prostate cancer across all the phases of care. The findings could guide policymakers in allocating resources more efficiently.