Cantarero-Prieto David, Lera Javier, Lanza-Leon Paloma, Barreda-Gutierrez Marina, Guillem-Porta Vicente, Castelo-Branco Luis, Martin-Moreno Jose M
Department of Economics, University of Cantabria and Research Group of Health Economics and Health Services Management-Valdecilla Biomedical Research Institute (IDIVAL), 39011 Santander, Spain.
Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain.
Cancers (Basel). 2022 Aug 24;14(17):4088. doi: 10.3390/cancers14174088.
Prostate cancer has huge health and societal impacts, and there is no clear consensus on the most effective and efficient treatment strategy for this disease, particularly for localized prostate cancer. We have reviewed the scientific literature describing the economic burden and cost-effectiveness of different treatment strategies for localized prostate cancer in OECD countries. We initially identified 315 articles, studying 13 of them in depth (those that met the inclusion criteria), comparing the social perspectives of cost, time period, geographical area, and severity. The economic burden arising from prostate cancer due to losses in productivity and increased caregiver load is noticeable, but clinical decision-making is carried out with more subjective variability than would be advisable. The direct cost of the intervention was the main driver for the treatment of less severe cases of prostate cancer, whereas for more severe cases, the most important determinant was the loss in productivity. Newer, more affordable radiotherapy strategies may play a crucial role in the future treatment of early prostate cancer. The interpretation of our results depends on conducting thorough sensitivity analyses. This approach may help better understand parameter uncertainty and the methodological choices discussed in health economics studies. Future results of ongoing clinical trials that are considering genetic characteristics in assessing treatment response of patients with localized prostate cancer may shed new light on important clinical and pharmacoeconomic decisions.
前列腺癌对健康和社会有着巨大影响，对于这种疾病，尤其是局限性前列腺癌，最有效和高效的治疗策略尚无明确共识。我们回顾了描述经合组织国家局限性前列腺癌不同治疗策略的经济负担和成本效益的科学文献。我们最初识别出315篇文章，深入研究了其中13篇（符合纳入标准的文章），比较了成本、时间段、地理区域和严重程度等社会视角。由于生产力损失和护理负担增加，前列腺癌带来的经济负担显著，但临床决策的主观变异性比理想情况更大。干预的直接成本是治疗较轻前列腺癌病例的主要驱动因素，而对于较严重的病例，最重要的决定因素是生产力损失。更新、更经济实惠的放疗策略可能在早期前列腺癌的未来治疗中发挥关键作用。我们结果的解读取决于进行全面的敏感性分析。这种方法可能有助于更好地理解参数不确定性以及健康经济学研究中讨论的方法选择。正在进行的考虑基因特征以评估局限性前列腺癌患者治疗反应的临床试验的未来结果，可能会为重要的临床和药物经济学决策带来新的启示。
