Abstract

GABELA, NC; BHADREE, S  and  MATHIBE, LJ. Costs of managing castrate-resistant metastatic prostate cancer patients at Inkosi Albert Luthuli Central Hospital. S. Afr. j. surg. [online]. 2021, vol.59, n.4, pp.176-178. ISSN 2078-5151.  http://dx.doi.org/10.17159/2078-5151/2021/v59n4a3327.

BACKGROUND: Metastatic castration-resistant prostate cancer (mCRPC) has a five-year survival rate of 30% despite the availability of expensive therapeutic agents. This study investigated the costs to a tertiary public hospital of the management of mCRPC with various therapeutic agentsMETHODS: Between 1 January 2017 and 24 November 2019 the records of patients who were diagnosed with mCRPC and received chemotherapy (docetaxel) in combination with goserelin (a luteinising hormone-releasing hormone [LHRH]), or bicalutemide (an anti-androgen) at the Inkosi Albert Luthuli Central Hospital were analysed. The activity-based costing (ABC) model was used to calculate the medicine costs and other expenses incurred by the hospitalRESULTS: During the study period, 64 patients, mean age 66 years (± 8.7) at first visit, met the inclusion criteria of this study. The total cost incurred by the hospital was R10 338 559. On average, a total of R161 540 (SEM R22 699.00) per patient was incurred by the hospital. There was 60% reduction (p = 0.01), after the average period of 4 months (± 2.9), in PSA levels in patients who received goserelin monotherapyCONCLUSION: The therapeutic gain from extremely expensive therapy in mCRPC patients requires evaluation of clinical response and survival data to justify the expense

Keywords : prostate cancer; prostate-specific antigen; chemotherapy; activity-based costing.

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