OBJECTIVES: To describe the direct medical costs of patients diagnosed with prostate cancer at the mHSPC stage, affiliated in a health insurance company and treated in a regional reference center in Cartagena, Colombia.

METHODS: Cross-sectional, retrospective cost analysis study using macro costing method sourcing data from administrative records and insurance claims between 2021-2022. Patients treated with chemotherapy + antiandrogens and/or bone protectors and/or reported metastasis were categorized as metastatic. Metastatic patients treated with chemotherapy + enzalutamide/abiraterone were categorized as metastatic castration-resistant (mCRPC). If they reported treatment with radiotherapy + (enzalutamide/bicalutamide/apalutamide) or (orchidectomy + antiandrogens), they were categorized as hormone-sensitive metastatic disease (mHSPC). Regarding costs, an estimate of frequency of use of services was performed, and the aggregation of the cost for services from the insurer's perspective using the HealthCare Delivery Records (RIPS) public database[1]. Finally, an adjustment for differences in average cost estimates is made, using identifiable characteristics. A generalized linear model with gamma distribution is performed to estimate cost ratios between different stages. An exchange rate of COP$3,932.59 Colombian per USD (2023) was used.

[1] Ministry of Health in Colombia. Sistema de Información de Prestaciones de Salud – RIPS. URL: https://www.minsalud.gov.co/proteccionsocial/Paginas/rips.aspx

RESULTS: Average annual cost of a patient in the metastatic stage is US$1,798.12 (IQR US$472.29 -US$4,742,04), that represents a larger frequency of use of laboratory testing and imaging versus those at non-metastatic stages (1.77 times, p < 0.01), specialist out-patient visits (1.33 times, p < 0.01) and hospitalization (1.8 times, p < 0 .01). When analyzed the mHSPC subgroup, average annual costs was US$1,172.85 (IQR US$381.04 - US$3,705.99) and for the metastatic castration-resistant patients (mCRPC) of US$5,970.85 (IQR US$2,224.47 - US$15,128.14).

CONCLUSIONS: The median costs of castration-resistant group are 5,09 times higher than the hormone-sensitive stage group for patients with metastatic prostate cancer.