ZHAW Zurich University of Applied Sciences, School of Management and Law, Winterthur Institute of Health Economics, Winterthur, Switzerland.
ZHAW Zurich University of Applied Sciences, School of Management and Law, Winterthur Institute of Health Economics, Winterthur, Switzerland; Helsana Group, Zurich, Switzerland.
Eur J Cancer. 2024 Jun;204:114072. doi: 10.1016/j.ejca.2024.114072. Epub 2024 Apr 24.
Prostate cancer (PC) is the most prevalent cancer in men in Switzerland. However, evidence on the real-world health care use of PC patients is scarce. The aim of this study is to describe health care utilization, treatment patterns, and medical costs in PC patients over a period of five years (2014-2018).
We used routinely collected longitudinal individual-level claims data from a major provider of mandatory health insurance in Switzerland. Due to the lack of diagnostic coding in the claims data, we identified treated PC patients based on the treatments received. We described health care utilization and treatment pathways for patients with localized and metastatic PC. Costs were calculated from a health care system perspective.
A total of 5591 PC patients met the inclusion criteria. Between 2014 and 2018, 1741 patients had outpatient radiotherapy for localized or metastatic PC and 1579 patients underwent radical prostatectomy. 3502 patients had an androgen deprivation therapy (ADT). 9.5% of these patients had a combination therapy with docetaxel, and 11.0% had a combination with abiraterone acetate. Docetaxel was the most commonly used chemotherapy (first-line; n = 413, 78.4% of all patients in chemotherapy). Total medical costs of PC in Switzerland were estimated at CHF 347 m (95% CI 323-372) in 2018.
Most PC patients in this study were identified based on the use of ADT. Medical costs of PC in Switzerland amounted to 0.45% of total health care spending in 2018. Treatment of metastatic PC accounted for about two thirds of spending.
前列腺癌(PC)是瑞士男性中最常见的癌症。然而,关于 PC 患者实际医疗保健使用情况的证据很少。本研究旨在描述五年来(2014-2018 年)PC 患者的医疗保健利用、治疗模式和医疗费用。
我们使用瑞士一家主要的强制性医疗保险提供商的常规收集的纵向个人水平索赔数据。由于索赔数据中缺乏诊断编码,我们根据所接受的治疗来确定治疗的 PC 患者。我们描述了局限性和转移性 PC 患者的医疗保健利用和治疗途径。成本是从医疗保健系统的角度计算的。
共有 5591 名 PC 患者符合纳入标准。2014 年至 2018 年期间,有 1741 名患者接受了局限性或转移性 PC 的门诊放疗,有 1579 名患者接受了根治性前列腺切除术。有 3502 名患者接受了雄激素剥夺治疗(ADT)。其中 9.5%的患者采用多西他赛联合治疗,11.0%的患者采用阿比特龙联合治疗。多西他赛是最常用的化疗药物(一线治疗;所有接受化疗的患者中有 413 名,占 78.4%)。2018 年,瑞士 PC 的总医疗费用估计为 3.47 亿瑞士法郎(95%CI 3.23-3.72)。
本研究中的大多数 PC 患者是根据 ADT 的使用情况确定的。2018 年,瑞士 PC 的医疗费用占总医疗支出的 0.45%。转移性 PC 的治疗占支出的三分之二左右。