OBJECTIVES: Estimate the disease specific costs of prostate cancer patients during the health states of nonmetastatic castration-resistant prostate cancer (NM-CRPC) and metastatic castration-resistant prostate cancer (M-CRPC).

METHODS: This cohort analysis contains 211 prostate cancer patients from the MUHC. An algorithm of detecting NM-CRPC and M-CRPC was based on increases of prostate specific antigen (PSA) levels after castration and the detection of metastasis. Consecutively, the mean time per health state was identified. The usage of imagery tests, hospital visits and treatments was extracted from the patients files and the mean usage per resource was calculated for 30 days in the given health state. Resources price were obtained from the RAMQ List of Medications when available, when unavailable prices were obtained from the MUHC internal prices lists. This cost analysis was performed by health care system perspective.

RESULTS: Mean duration of NM-CRPC was 26.07 months while duration of M-CRPC was 20.79 months, with 62 and 68 patients per health state respectfully. The average disease specific resource utilisation per patient for 30 days was $786 for NM-CRPC and $2,210 for M-CRPC health states with the cost driver being chemotherapy or prescription drugs different than ADT. The resource utilization that increased the most from NM-CRPC to M-CRPC was emergency visits (increased 26 times), while costs due to ADT, chemotherapy or prescription drugs different than ADT and radiotherapy increased by more than a twofold. The total average cost for NM-CRPC health state was $20,457 compared to $45,956 for M-CRPC health state.

CONCLUSIONS: The disease specific resource utilisation costs for a patient in M-CRPC are significantly higher than the costs of NM-CRPC. This being said it would be interesting to study the total healthcare costs from a societal perspective in order the improve the cost management of PCa.