Clinico-economical analysis in the evaluation of the surgical outcomes of the prostate cancer treatment

Apolihin O.I., Katibov M.I.

Clinico-economical analysis was performed for 4 different treatment methods of the prostate cancer. The operations performed were: open radical retropubic prostatectomy in 215 patients, brachytherapy (I-125) in 213 patients, high intensity focused ultrasound (HIFU) in 45 patients, laparoscopic (extraperitoneoscopic) radical prostatectomy in 40 patients. The treatment costs were direct and indirect. Direct costs were the costs for the preparation and the implementation of the operation: costs of the preoperative investigation, neoadjuvant treatment and in-hospital period. Indirect costs of the in-hospital period were the costs for sick-leave certificate reimbursement and economical loss of the national produce underproduction. Comparison of the costs and results of the treatment was made using “costefficacy” and “costutility” analysis. During the “costefficacy” analysis the recurrence-free survival was chosen as the measure of the treatment results. During the “cost-utility” analysis the results of the treatment were evaluated using EQ-5D questionnaire for quality of the life assessment. The best results aer both type of analyses had HIFU. Though, these results could be achieved only when HIFU is implemented regularly. Brachytherapy was the least economically-effective method due to high costs, while it showed on of the best clinical results. Drawing a conclusion, the results of this study could be used to optimize the costs and to increase the efficacy of the surgical treatment for prostate cancer.

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