AUA 2013 - Session Highlights: Modeling management strategies for stage I seminoma: Direct and indirect costs for the first five years

SAN DIEGO, CA USA (UroToday.com) - Drs. Johnston, Nichols, and Porter used Markov model-based analyses to compare the costs of three management strategies (surveillance, chemotherapy, and radiotherapy) for management of patients with stage I seminoma.

They collected model parameters from Washington State Comprehensive Hospital Abstract Reporting System (CHARS), published literature, and Medicare reimbursement amounts. Costs and the likely time burden to the patient over the first five years of treatment were calculated; 5% annual health inflation rate was included in their calculations.

The absolute difference between the three treatment costs was $ 1548.04 (17.1%) over the first five years. The model predicted an initial cost premium for both carboplatin (1 cycle = $9199.80, 2 cycle = $10613.85) and radiotherapy ($ 9532.80) compared with surveillance ($ 9065.31) alone. They found that radiotherapy (145.78 hours) and surveillance (123.02 hours) requires slightly more patient time than carboplatin (1 cycle = 93.2 hours and 2 cycle = 106.3 hours) over the first 5 years.

Authors concluded that no treatment strategy was dramatically cheaper in the first 5 years. During the first 5 years of treatment, surveillance is the most cost effective, even when patient time is taken into account. The absolute cost difference between the three options was only 17.1% of the total costs. Due to the probable late side effects of radiotherapy, and possibly chemotherapy, perhaps surveillance is a safe, cost, and time-effective treatment option for management of patients with stage I pure seminoma testis cancer.

Presented by Richard Johnston, Craig Nichols, and Chris Porter at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA


Reported for UroToday.com by Reza Mehrazin, MD

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