Watchful Waiting Shows Cost Advantage in Prostate Cancer

Approach with active surveillance in low-risk cases may offer big savings versus radical prostatectomy
By Eric Metcalf
HealthDay Reporter

THURSDAY, Sept. 30 (HealthDay News) -- Watchful waiting with active surveillance (WWAS) may steeply reduce costs compared to radical prostatectomy in men with low-risk prostate cancer, according to research published in the September issue of Urology.

Anthony T. Corcoran, M.D., of the University of Pittsburgh School of Medicine, and colleagues analyzed data from a model incorporating Medicare reimbursements in 2008 for radical prostatectomies in a single institution and two 15-year approaches to WWAS varying by follow-up protocol and conversion to active treatment.

The researchers found that up-front radical prostatectomy cost $15,235 per person, factoring in the cost of the surgery, complications, and 15 years of follow-up. Costs per person in the WWAS approaches ranged from $6,558 to $11,992. This represented a cost reduction of 43 to 78.7 percent compared with up-front radical prostatectomy.

"Saving men from unnecessary prostate cancer treatments may decrease costs, preserve function, and ultimately improve quality of life. Incentivizing less treatment for appropriately selected individuals is the best approach from a societal perspective. Ultimately, our goal as clinicians should be to provide the right care for the right patient at the right time. Therefore, improving the evidence base for active surveillance protocols to better characterize and minimize patient risks (i.e., metastatic disease) is necessary as this approach becomes increasingly popular," write the authors of an accompanying editorial.

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