OBJECTIVES: Hormone deprivation is an integral part of advanced PCa treatment. Aim of this study was the analysis of real-world data on GnRHa regarding prescription patterns, hospitalisation and hospital costs.

METHODS: Healthcare claims data from 75 German Statutory Health Insurances (2010–2015, n=4,205,227) were analysed (1 year enrolment before GnRHa, 1 index quarter (InQ) of initial GnRHa and ≥ 2 years follow-up (FU)).

RESULTS: In total 2,382 PCa patients met the inclusion criteria, average age 75-years-old. Leuprorelin (Leu, 56.6%) was prescribed most frequently, followed by leuprorelin hybrids (Hyb, 13.1%), triptorelin (Trp, 12.9%), buserelin (10.2%), goserelin (Gos, 5.0%) and degarelix (Deg, 2.2%). For first GnRHa prescriptions, 70% of the patients were lymph node-negative or had no metastases. Around 11% of patients stopped GnRHa treatment after first prescription, 17.6% changed initial therapy after a mean of 457 days, in the Hyb group on average 100 days quicker than in the agonist group (p=0.016). The proportion of patients with at least one switch after first GnRHa prescription was 21.4% in the Trp, 11.6% in the Leu (p<0.001), 53.9% in the Deg (p<0.001) and 38.7% in the Gos group (p<0.001), respectively.

In the InQ 26.4% of patients had ≥ 1 inpatient hospitalisation [Trp 22.4%; Gos 30.3%], with an average hospital stay/patient of 3 days [Trp 2.4; Gos 4.5]. The annual hospitalisation rate was between 36.2 and 40.7%, the average hospital stay in the entire FU ranged from 17.6 (Trp) to 20.8 days (Hyb). Hospital costs in the InQ were on average EUR 1,200 [Trp 987.5; Gos 1,803.1], per FU year approx. EUR 3,000. In the Trp cohort the overall costs (InQ+3 years) were 8,116.1 EUR, i.e. below the average costs of EUR 9,476.2.

CONCLUSIONS: This research reveals main differences in androgen deprivation therapy concerning prescription pattern, hospitalisation rate and allocated healthcare costs.