McEwan A J, Amyotte G A, McGowan D G, MacGillivray J A, Porter A T
Cross Cancer Institute, Edmonton, Alberta, Canada.
Nucl Med Commun. 1994 Jul;15(7):499-504. doi: 10.1097/00006231-199407000-00002.
The objectives of the study were to estimate the cost of medical care for patients recruited into the Trans Canada trial of Metastron (89Sr-chloride) as adjunct therapy in patients with prostate cancer metastatic to bone and to compare the costs of those receiving Metastron with those receiving placebo. Data from case report forms, hospital records and, where necessary, telephone follow-up were used. Twenty-nine patients, recruited into the trial at the Cross Cancer Institute, were followed from time of entry into the trial over the balance of their lifetime. Data were costed by reference to fee schedule, pharmacy and government and hospital defined costs as indirect (investigations, outpatient visits and total and tertiary hospital inpatient days) and direct (analgesics, hormones, radiotherapy and transfusions). Meaningful differences in analgesic, hormone and radiotherapy costs were seen between the two groups, with the group receiving Metastron showing a lifetime reduction of Can $1720 per person when compared with placebo. A reduction of Can $5696 per patient in the Metastron group was shown based upon requirements for admission for tertiary care; however, if total hospital stay costs are calculated there is no difference between the two groups. This retrospective study suggests that treatment with Metastron can bring about meaningful reductions in lifetime management costs in patients with advanced prostate cancer. These findings should be correlated with the significant improvement in quality of life reported in the Trans Canada study and appear to offer financial support to the clinical rationale for the use of Metastron in the palliative treatment of these patients.
本研究的目的是估算参与加拿大转移性前列腺癌锶-89氯化物辅助治疗试验（Trans Canada trial of Metastron）的患者的医疗费用，并比较接受Metastron治疗的患者与接受安慰剂治疗的患者的费用。使用了病例报告表、医院记录数据，并在必要时进行电话随访。在十字癌症研究所招募进入试验的29名患者，从进入试验时起对其余生进行随访。数据根据收费表、药房以及政府和医院定义的间接成本（检查、门诊就诊以及综合医院和三级医院住院天数）和直接成本（镇痛药、激素、放疗和输血）进行成本核算。两组在镇痛药、激素和放疗成本方面存在显著差异，与安慰剂组相比，接受Metastron治疗的组每人终生成本降低了1720加元。根据三级护理入院需求，Metastron组每位患者的成本降低了5696加元；然而，如果计算总住院费用，两组之间没有差异。这项回顾性研究表明，Metastron治疗可显著降低晚期前列腺癌患者的终生管理成本。这些发现应与加拿大研究报告的生活质量显著改善相关联，似乎为在这些患者的姑息治疗中使用Metastron的临床合理性提供了经济支持。
