Sennfält Karin, Carlsson Per, Thorfinn Johan, Frisk Jessica, Henriksson Martin, Varenhorst Eberhard
Center for Medical Technology Assessment, Linköping University Hospital, Sweden.
Scand J Urol Nephrol. 2003;37(3):226-31. doi: 10.1080/00365590310008109.
In two previous studies we calculated direct costs for men with prostate cancer who died in 1984-85 and 1992-93, respectively. We have now performed a third cost analysis to enable a longitudinal cost comparison. The aim was to calculate direct costs for the management of prostate cancer, describe the economic consequences of technological changes over time and estimate total direct costs for prostate cancer in Sweden.
A total of 204 men in a defined population with a diagnosis of prostate cancer and who died in 1997-98 were included. Data on utilization of health services were extracted from clinical records from time of diagnosis to death from a university hospital and from one county hospital in the county of Ostergötland.
The average direct cost per patient has been nearly stable over time (1984-85: 143 000 SEK; 1992-93: 150 000 SEK; 1997-98: 146 000 SEK). The share of costs for drugs increased from 7% in 1992-93 to 17% in 1997-98. The total direct costs for prostate cancer in Sweden have increased over time (1994-85: 610 MSEK; 1992-93: 860 MSEK; 1997-98: 970 MSEK).
Two-thirds of the total cost is incurred by inpatient care. The share of the total costs for drugs is increasing due to increased use of gonadotrophin-releasing hormone analogues. Small changes in average direct costs per patient despite greater use of technology are explained by the fact that more prostate cancers are detected at the early stages.
在之前的两项研究中，我们分别计算了1984 - 1985年和1992 - 1993年死于前列腺癌男性患者的直接成本。我们现在进行了第三次成本分析，以便进行纵向成本比较。目的是计算前列腺癌治疗的直接成本，描述技术变革随时间推移的经济后果，并估算瑞典前列腺癌的总直接成本。
纳入了在特定人群中确诊为前列腺癌且于1997 - 1998年死亡的204名男性。从一家大学医院和东约特兰省的一家县医院的临床记录中提取了从诊断到死亡期间的医疗服务利用数据。
每位患者的平均直接成本随时间推移基本保持稳定（1984 - 1985年：143,000瑞典克朗；1992 - 1993年：150,000瑞典克朗；1997 - 1998年：146,000瑞典克朗）。药物成本所占比例从1992 - 1993年的7%增加到1997 - 1998年的17%。瑞典前列腺癌的总直接成本随时间增加（1984 - 1985年：6.1亿瑞典克朗；1992 - 1993年：8.6亿瑞典克朗；1997 - 1998年：9.7亿瑞典克朗）。
总成本的三分之二由住院治疗产生。由于促性腺激素释放激素类似物使用增加，药物总成本所占比例正在上升。尽管技术使用增加，但每位患者平均直接成本变化不大，这是因为更多的前列腺癌在早期被检测到。
