Background: Prostate cancer is the second most common malignant cancer among men, and according to the predictions, the estimated number of new cases will substantially grow in the coming years. Therefore, the costs of the disease will increase as well. Methods: We conducted a literature review of the state of knowledge about the costs of treatment and the economic burden of prostate cancer. The vast majority of studies were focused on direct costs only, which clearly shows the literature gap. Results: We focused on the estimates of direct costs, i.e., treatment of prostate cancer, adjuvant and neoadjuvant treatment, and supportive and palliative care, and indirect costs. Cost-effectiveness analyses indicated that docetaxel combined with androgen deprivation therapy (ADT) was the most cost-effective strategy for metastatic hormone-sensitive prostate cancer (incremental cost-effectiveness ratio (ICER): USD 13,647). In contrast, novel therapies such as PARP inhibitors and whole-genome-sequencing-guided treatments were not cost-effective unless drug prices were reduced by 47–70%. In the United States, 5-year cumulative treatment costs ranged from USD 48,000 for conservative management to over USD 91,000 for radiotherapy, while out-of-pocket expenses averaged AUD 1172 in Australia. Indirect costs were also considerable, with Slovakia reporting an increase in sick leave costs from EUR 1.2 million in 2014 to EUR 2.1 million in 2022. Conclusions: Metastatic hormone-sensitive prostate cancer and metastatic castration-resistant prostate cancer were the most frequent categories for various treatment cost evaluations. A few specific combinations of drugs were cost-effective only under the condition of dropping the unit prices of a medication. Further summarizing, reviewing, and developing a methodology for standardized comparisons are needed.
背景：前列腺癌是男性中第二常见的恶性肿瘤，根据预测，未来几年新发病例数将显著增长，因此该疾病的治疗成本也将随之增加。 方法：我们对前列腺癌治疗成本及经济负担的相关研究文献进行了系统性回顾。绝大多数研究仅关注直接成本，这明显揭示了现有文献的空白。 结果：我们重点分析了直接成本（包括前列腺癌治疗、辅助与新辅助治疗、支持性与姑息治疗）及间接成本的评估数据。成本效益分析表明，多西他赛联合雄激素剥夺疗法是转移性激素敏感性前列腺癌最具成本效益的治疗策略（增量成本效益比为13,647美元）。相比之下，新型疗法如PARP抑制剂和全基因组测序指导治疗的成本效益较低，除非药物价格降低47%至70%。在美国，5年累计治疗费用从保守治疗的48,000美元到放疗的91,000美元以上不等，而澳大利亚患者的自付费用平均为1,172澳元。间接成本同样显著，斯洛伐克的数据显示病假成本从2014年的120万欧元增至2022年的210万欧元。 结论：转移性激素敏感性前列腺癌和转移性去势抵抗性前列腺癌是各类治疗成本评估中最常见的类别。部分特定药物组合仅在单价降低的条件下才具有成本效益。未来需要进一步总结、回顾并建立标准化比较的方法学体系。
肿瘤(癌症)患者之家