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Health Care Spending for High-Resource Patients With Prostate Cancer

February 01, 2021

Study findings show 5% of men diagnosed with prostate cancer accounted for 26% of the total cost of care for all men diagnosed in 2009 (Urol Oncol. 2021;39[2]:130.e17-130.e24. doi:10.1016/j.urolonc.2020.09.033).

“Prostate cancer ranks among the top 5 cancers in contribution to national expenditures. Previous reports have identified that 5% of the population accounts for 50% of the nation's annual health care spending,” wrote Maxine Sun, PhD, Department of Urology, Brigham and Women's Hospital (Boston, MA), and colleagues.

This study aimed to investigate determinants and health care resource utilization (HCRU) of high-resource patients with prostate cancer.

Using the SEER database, researchers identified men with a primary diagnosis of prostate cancer in 2009. High-resource patients were defined as the top 5% of the sum of total cost incurred for all services rendered per beneficiary.

A total of 12,875 men were identified, 646 of whom were top 5% high-resource patients. This top 5% spent $62,474,504, comprising 26% of total costs of prostate cancer treatment in 2009. The average cost for a patient who was included in the top 5% was $96,710, while the average spent for a patient among the bottom 95% was $14,664.

Determinants of being a high-resource patient included older age, Charlson Comorbidity Index ≥2, and advanced disease. Of the patients included in the top 5%, 210 (32.5%) died within 1 year of diagnosis compared with 606 (5%) in the bottom 95%.

“[5%] of men diagnosed with [prostate cancer] bore 26% of the total cost incurred for all men diagnosed with the disease in 2009,” concluded Dr Sun and colleagues.

“Multidisciplinary care and shared decision-making is encouraged for such patients to better manage cost and quality of care,” they said.—Marta Rybczynski

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