OBJECTIVES: There is limited real-world data on healthcare resource utilization (HCRU) for patients with metastatic castration resistant prostate cancer (mCRPC). The aim was to assess current specialized care HCRU and cost per patient with mCRPC in Finland.

METHODS: All patients diagnosed with prostate cancer (ICD-10: C61) from 2013 to 2021 were identified from the Hospital districts of Helsinki and Uusimaa, and Southwest Finland, respectively, covering approximately 40% of the Finnish population. Specialized care data were collected from the electronic medical records of the respective hospital data lakes. HCRU-related costs were derived using publicly available unit costs. All visits, treatments, and procedures are included in the prices as national averages according to the specialty and type of visit. PC specificity was determined based on the recorded C61 diagnostic codes.

RESULTS: We identified 31 307 prostate cancer patients, of whom 2 475 developed mCRPC during the study period, with a median age of 76 years (inter-quantile range 70-82). The number of outpatient contacts was 22.3 (95% CI:21.7-23.0) per patient year, of which 60% were PC-specific. Patients had 1.2 (95% CI:1.1-1.2) hospitalizations per year, with 5.0 (95% CI: 4.7-5.4) inpatient days, the majority of which (76%) were not documented as PC-related hospitalizations (76%). In addition, patients had 3.6 (95% CI:3.4-3.9) visits to radiotherapy per year, mostly driven by PC. All-cause costs per patient during the follow-up period were 19 277€ (95% CI:18 542-20 016€) for outpatient costs and 9 870€ (95% CI: 9 118-10 685€) for inpatient costs. No major differences were detected in costs between the first-line treatment and the entire follow-up period.

CONCLUSIONS: Patients with mCRPC have a significant number of specialty care HCRU that are not directly associated with C61 diagnosis, indicating a significant burden of disease outside the confines of PC management and treatment.