Department of Urology, Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Urology, Zhujiang Hospital of Southern Medical University, Guangzhou City, China.
J Med Econ. 2024 Jan-Dec;27(1):361-369. doi: 10.1080/13696998.2024.2320001. Epub 2024 Mar 11.
This study assessed the treatment patterns, healthcare resource utilization (HRU), costs, and annual prevalence and incidence of metastatic hormone-sensitive prostate cancer (mHSPC) and nonmetastatic castration-resistant prostate cancer (nmCRPC) in China.
A retrospective study was conducted using electronic medical records (EMR) of patients with prostate cancer from three tertiary-care hospitals in China between January 2014 and March 2021. Descriptive statistics were used to analyze study outcomes.
In total, 1086 patients with mHSPC and 679 patients with nmCRPC were included. From 2015 to 2020, the annual percentage of prevalent and incident cases of mHSPC decreased from 22.4% to 20.0% and 11.1% to 6.9%, respectively; for nmCRPC, these increased from 3.8% to 13.6% and 3.3% to 8.4%. Androgen-deprivation therapy and first-generation antiandrogens (bicalutamide or flutamide) were the most frequently prescribed prostate cancer-related medications at baseline and follow-up in patients with mHSPC. Bicalutamide was the most frequently prescribed prostate cancer-related medication during follow-up in patients with nmCRPC. For mHSPC, inpatient admission costs were the highest, with the median (interquartile range) costs per person-month being USD 403.00 (USD 85.50-1226.20), whereas outpatient visit costs were the highest for nmCRPC (USD 372.60 [USD 139.50-818.50]).
EMR-based study design did not capture treatment patterns, HRU and associated costs, and healthcare encounters that occurred outside of participating hospitals, which could have led to underestimation of the true disease burden.
A contrasting trend of a decline in the prevalence and incidence of mHSPC and an increase in these for nmCRPC was observed between 2015 and 2020 in China. Androgen-deprivation therapy and first-generation antiandrogens were the most frequently prescribed prostate cancer-related medications. Healthcare resource utilization was driven by inpatient costs in mHSPC and outpatient costs in nmCRPC.
本研究评估了中国转移性激素敏感前列腺癌（mHSPC）和非转移性去势抵抗性前列腺癌（nmCRPC）的治疗模式、医疗资源利用（HRU）、成本以及年度患病率和发病率。
本研究使用中国三家三级医院的电子病历（EMR）进行了回顾性研究，时间范围为 2014 年 1 月至 2021 年 3 月。使用描述性统计分析来分析研究结果。
共纳入 1086 例 mHSPC 患者和 679 例 nmCRPC 患者。2015 年至 2020 年，mHSPC 的现患率和发病率分别从 22.4%降至 20.0%和从 11.1%降至 6.9%；nmCRPC 则从 3.8%增至 13.6%和从 3.3%增至 8.4%。在 mHSPC 患者中，雄激素剥夺疗法和第一代抗雄激素（比卡鲁胺或氟他胺）是基线和随访时最常开的前列腺癌相关药物。在 nmCRPC 患者中，比卡鲁胺是随访时最常开的前列腺癌相关药物。对于 mHSPC，住院治疗费用最高，人均月费用中位数（四分位距）为 403.00 美元（85.50-1226.20 美元），而 nmCRPC 的门诊就诊费用最高（372.60 美元[139.50-818.50 美元]）。
基于 EMR 的研究设计并未捕获治疗模式、HRU 及相关成本，以及发生在参与医院之外的医疗接触情况，这可能导致疾病负担的真实情况被低估。
2015 年至 2020 年间，中国 mHSPC 的现患率和发病率呈下降趋势，nmCRPC 则呈上升趋势。雄激素剥夺疗法和第一代抗雄激素是最常开的前列腺癌相关药物。mHSPC 的 HRU 由住院费用驱动，nmCRPC 则由门诊费用驱动。
