Population-level resources and costs associated with low-risk prostate cancer patients on active surveillance

Background — This study was conducted to evaluate the population-level healthcare resource utilization (HCRU) and costs for men diagnosed with low-risk prostate cancer (PCa) either on active surveillance (AS) or not on AS, in which AS was defined as receiving no treatment within 1 year of diagnosis and two biopsies.

Methods — AS men aged 40 to 105 years, diagnosed with stage I or II PCa, had a prostate-specific antigen (PSA) level < 20 ng/mL, a Gleason score between 5 and 7, and were matched (1:1) with men not receiving AS. The index date is defined as the date 1 year after PCa diagnosis. HCRU and costs were assessed using a macro-based costing methodology and costs standardized to 2023 CAD. Means (SD) and medians (interquartile ranges) per person-year values were reported annually.

Results — During the year leading up to the index date, the mean number of HCRU per patient-year (PPY) was significantly lower for the AS cases versus non-AS in terms of cancer clinic visits (1.7 vs. 26.7), hospital outpatient clinic visits (3.6 vs. 4.9), all physician visits (16.3 vs. 17.5), and specialist visits (10.7 vs. 11.6). The mean overall cost PPY was $6100 ± $12,400 for AS cases and $10,400 ± $17,800 for non-AS men (median overall cost PPY= $3500 [IQR: $2100-$5700] vs. $3700 [IQR: $2100-$7200] (p = 0.0001, respectively).

Conclusions — HCRU and costs calculated for AS and non-AS low-risk PCa men indicate the cost savings potential for AS.