OBJECTIVES : To estimate the disease burden of prostate cancer (PC) under current treatment pattern in China.

METHODS : A decision-analytic model was constructed to simulate the Chinese patients with PC and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. Literature search was conducted to identify appropriate evidence to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of PC.

RESULTS : The Chinese PC patients (68.8 years old) were associated with reduced average overall survival by 4.583 years (9.032 years vs. 13.615 years), reduced average QALY by 2.037 QALY (6.622 years vs. 8.659 years), and increased average life-time direct medical costs by ¥269,197 (¥355,948 vs. ¥86,751). Lifetime QALY associated with PC was highly sensitive to utility of patients with (change: 1.372 QALY) and without radical prostatectomy (change: 1.389 QALY), proportions of distant metastasis (change: -0.930 QALY) and high-risk patients (change: 0.641 QALY), and treatment effect of radical prostatectomy (change: -0.593 QALY). The lifetime direct medical costs associated with PC patients was highly sensitive to mortality (change: ¥-67,231) and treatment effects of surgical castration therapy (change: ¥-50,422), brachytherapy combined with external beam radiation therapy (change: ¥47,440), and androgen deprivation therapy (change: ¥-41,375). The probabilistic sensitivity analysis with 5,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY (-1.813 QALY, -2.382 to -1.154 QALY) and increased lifetime direct medical costs (¥283,506, ¥210,436 to ¥405,878).

CONCLUSIONS : The disease burden of PC in Chinese patients was mainly characterized with increased medical costs that were highly sensitive to treatments during the disease course.