An economic evaluation of conservative management and cryotherapy in patients with localized prostate cancer

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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.


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.


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.

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