Journal article
Significant financial differences of chemical and surgical androgen deprivation in a contemporary cohort
Translational andrology and urology, Vol.11(9), pp.1252-1261
08/08/2022
DOI: 10.21037/tau-22-191
PMCID: PMC9547165
PMID: 36217391
Abstract
Background: Androgen deprivation therapy (ADT) remains a cornerstone of treatment for advanced prostate cancer. Few men elect for surgical castration via bilateral orchiectomy. We sought to compare the relative difference in financial charges between chemical and surgical ADT in men.Methods: Billing data was obtained for patients with metastatic prostate cancer receiving chemical ADT and who had bilateral orchiectomy from 2014-2019. Men had chosen intervention based on personal preference. We compared charges of ADT administration for chemical ADT and overall charges for bilateral orchiectomy. We determined the time chemical ADT patient charges surpassed those of surgical charges, as well as the net present value (NPV) of hypothetical savings for electing surgery over various ADT agents.Results: One hundred and thirty-seven patients receiving chemical ADT and 7 patients who had undergone bilateral orchiectomy were analyzed. Median and mean surgical charges were $13,000. By 38 weeks following treatment initiation, 50% of chemical ADT patients had surpassed surgical charges, with 95% at 2 years. The NPV in savings for a median patient varied between ADT agent and was highest at $167,000 for leuprolide.Conclusions: In less than a year, the median chemical ADT patient charges were greater than surgical castration. The NPV of electing surgery over ADT was the highest with leuprolide. Despite under-utilization, surgical castration remains a medically appropriate and cost-effective option for permanent ADT.
Details
- Title: Subtitle
- Significant financial differences of chemical and surgical androgen deprivation in a contemporary cohort
- Creators
- Charles J. Paul - University of IowaRohan Garje - Univ Iowa Hosp & Clin, Holden Comprehens Canc Ctr, Iowa City, IA USAKarl J. Kreder - Univ Iowa Hosp & Clin, Dept Urol, Iowa City, IA USASarah L. Mott - University of IowaPaul T. Gellhaus - Univ Iowa Hosp & Clin, Dept Urol, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Translational andrology and urology, Vol.11(9), pp.1252-1261
- DOI
- 10.21037/tau-22-191
- PMID
- 36217391
- PMCID
- PMC9547165
- NLM abbreviation
- Transl Androl Urol
- ISSN
- 2223-4683
- eISSN
- 2223-4691
- Publisher
- AME PUBLISHING COMPANY
- Number of pages
- 10
- Language
- English
- Date published
- 08/08/2022
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Obstetrics and Gynecology; Urology; Internal Medicine
- Record Identifier
- 9984319978902771
Metrics
24 Record Views