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Perioperative costs and charges of prostate brachytherapy and prostatectomy
Antoine A Makhlouf1, James C Boyd, Terrence N Chapman
1Department of Urology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
Objectives:
To compare the costs and charges incurred for transrectal ultrasound-guided brachytherapy (USBT) and radical prostatectomy (RP) at a single institution.
Methods:
From February 1998 to March 1999, 66 consecutive patients underwent potentially curative therapy for clinically localized prostate cancer. Thirty-seven were treated by USBT using palladium-103 brachytherapy and 29 by RP. Hospital costs and charges and professional fees were obtained for a 2-month period beginning 1 month before RP or USBT and compared between the two procedures.
Results:
The mean total charges for USBT ($26,320) and RP ($22,660) were not significantly different. Compared with RP, USBT incurred significantly lower operating room time cost ($628 for USBT versus $2093 for RP, P <0.05). The average cost of seeds for USBT was $6184, which resulted in higher technical costs for USBT than for RP ($12,209 versus $7746, P <0.05). This was offset by lower professional fees for USBT ($7575 versus $9531). The ratio of charge to cost was lower for USBT than for RP (2.2 versus 3.0).
Conclusions:
The total charges associated with brachytherapy appear similar to those associated with RP, although RP had relatively lower technical costs. Without a clear cost advantage of USBT over RP, the choice of therapy should continue to be primarily influenced by tumor characteristics, treatment efficacy, and patient preference.