Prostate cancer places a high economic burden on healthcare systems globally. International studies demonstrated significant impact to the health system, mainly due to increased hospitalization of advanced disease patients. In Brazil, a cohort study evaluated PCa medical-cost in an HMO resulting in R$4.640/year, with most of patients in earlier treatment stage. This study aims to evaluate medical-costs for the treatment of patients with PCa-wBM in the Brazilian Supplementary Health System (SHS).

METHODS:

This was designed as a retrospective database cohort study from an administrative database (Orizon) that covers part of the Brazilian SHS, during the period of Jan/2010-Dec/2015. The analysis focused on hospital costs and medical resources consumption of patients registered in the database with prostate cancer and bone metastasis according to selection criteria: ICD-10:C-61 register followed by ICD-10:C795 or M907 or register of bone-metastasis procedures; at least one PCa treatment and hospitalization or ambulatory admission. Study outcomes were: annualized overall hospital cost per patient, prostate cancer treatment types distribution, average hospital visits and Length of Stay(LOS).Currency rate:US$1=R$3,23.

RESULTS:

A cohort of 181 patients met the selection criteria for the study. During the follow-up period 21,5% of the patient cohort had exclusively one type of treatment, whereas 37,5% had Radiotherapy(RT), Hormonetherapy(HT) and Oncologic-therapy. Average cost/entrance was R$10.300, hospitalization and ambulatory costs was R$36.853 and R$5.627 respectively. Patient had entered the hospital 6,49-times per year, of which 2,64-times was hospitalized with an average LOS/hospitalization of 10,64-days. Annualized hospital cost/patient was R$107.387,66. Sub-group analysis had shown RT average cost/entrance of R$3.001 and oncologic-therapy of R$4.340. HT average cost/entrance was R$16.614, with disparity between ambulatory and hospitalization, R$4.538 and R$42.140 respectively.

CONCLUSIONS:

This cohort study showed high economic burden of hospital treatment of PCa wBM in the Brazilian SHS compared to previous study, mainly due to advanced disease stage that requires frequent hospital entrance and stay.