Metastatic Castration-Sensitive Prostate Cancer Brings Considerable Costs

Metastatic castration-sensitive prostate cancer is associated with a substantial cost impact over 2 years, according to study authors.

“Our study shows that all-cause health care costs in patients with nonmetastatic castration-sensitive prostate cancer increase between 2- and 4-fold following metastasis, with increases evident several months before metastatic diagnosis,” reported researchers. “All-cause health care cost increases were typically higher in patients diagnosed as de novo metastatic than in patients who progressed from nonmetastatic disease, a finding that could have potential implications for screening and treatment algorithms.”

The retrospective, observational cohort study included 3854 patients diagnosed with metastatic castration-sensitive prostate cancer between 2014 and 2016. Among participants, 2766 had Medicare insurance, and 1088 had commercial insurance. Patients with de novo metastatic castration-sensitive prostate cancer made up 28.9% of the Medicare population and 34.5% of the commercial insurance population in the study.

Adjusted incremental cost increases due to metastasis in patients first diagnosed with nonmetastatic cancer were an estimated $104,051 with Medicare and $93,334 with commercial insurance, assuming data are available for 24 months. Allowing for variation in the period of postindex follow-up, costs increases were an estimated $71,308 with Medicare and $82,336 with commercial insurance, researchers reported.

Among patients who were metastatic at diagnosis, cost increases due to metastasis were an estimated $180,932 with Medicare and $215,397 with commercial insurance, assuming 24-month postindex data availability. Allowing for variable postindex observation, costs increases were an estimated $113,253 with Medicare and $161,714 with commercial insurance.

“These results,” wrote researchers, “suggest that delaying metastasis, either through detection of localized disease prior to de novo manifestation or by initiating or intensifying treatment in patients with nonmetastatic castration-sensitive prostate cancer who are at most risk of progressing to metastatic disease, may be associated with potential health care cost reductions in addition to improved clinical outcomes.”

Reference:
Trinh QD, Chaves LP, Feng Q, Zhu J, Sandin R, Abbott T. The cost impact of disease progression to metastatic castration-sensitive prostate cancer. J Manag Care Spec Pharm. 2022;28(5):544-554. doi:10.18553/jmcp.2022.28.5.544