Pilot Project

David B. Samadi
David B. Samadi, MD
Associate Professor Urology
Mount Sinai School of Medicine

Economic Analysis of Current Treatment Options for Clinically Localized Prostate Cancer

Introduction: As the pressure increases on physicians to consider the economic impact of their treatment decisions, prostate cancer remains poorly understood from a financial perspective. Little comparative data is available on the costs ofthe various modem treatments for clinically localized prostate cancer.

Materials and Methods: We plan to examine the institutional costs of robotic and open prostatectomy, prostate brachytherapy, and conformal beam and intensity-modulated radiotherapy. The initial cost of each procedure will be calculated from hospital charge data, then converted into direct costs by the use of the cost-to-charge ratio. The cost of treatment of disease recurenceence and complications will be calculated in a similar manner. To calculate the overall costs of treatment, a Markov decision-tree analysis will be performed for each of the primary treatment options. Historical data will be used to establish the rates of recurrence and complication for each treatment. The model will be adjusted and recalculated for different rates of recurrence and complication, to account for differences in the effectiveness of the primary treatment.

Results: We will report the direct costs of the initial treatment of prostate cancer by surgery, brachytherapy, and external beam radiation. The costs of the treatment of cancer recurrence and treatment complications will also be calculated. Combining this data by the use of a Markov decision-tree will result in the overall cost of prostate cancer treatment at various rates of recurrence and complications.

Conclusions: We hope to generate a flexible economic model that can compare the costs of the various treatment options for clinically localized prostate cancer at different rates of recurrence and complication. This will help define the overall cost for the treatment of prostate cancer at varying risk levels by treatment modality.