Real-World Economic Outcomes of Patients with Localized Prostate Cancer Treated with External Beam Radiation Therapy or Radical Prostatectomy.

Background: External beam radiation therapy (EBRT) and radical prostatectomy (RP) are definitive options for patients with localized or locally advanced prostate cancer (LPC). Limited evidence exists on the post-treatment economic burden in these patients. Objective: This real-world analysis investigated healthcare costs among Medicare beneficiaries with LPC who received EBRT or RP as initial definitive treatment. Methods: This is a retrospective, longitudinal cohort study using Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Included were Medicare Fee-For-Service beneficiaries newly diagnosed with LPC at the age of ≥65 years during 2012-2019 and received either EBRT or RP as an initial definitive therapy. After the initial therapy, all-cause and prostate cancer-related costs were summarized and stratified by the earliest observed definitive therapy (RP vs EBRT) and the National Comprehensive Cancer Network risk classification (low/intermediate-risk [LIR-LPC] vs high-risk [HR-LPC]). Results: Of the 17 066 LPC patients treated with EBRT, 60% (N =10 321) had LIR-LPC and 40% (N = 6745) had HR-LPC. During the follow-up, the mean per-person-per-year all-cause cost was Conclusions: This real-world study on healthcare costs in patients with LPC treated with EBRT or RP showed HR-LPC is associated with significant incremental economic burden relative to LIR-LPC. The findings highlight the current unmet need for more cost-effective treatment strategies for HR-LPC.