Economic Burden of Prostate Cancer in Iran: Measuring Costs and Quality of Life

Prostate cancer (PCa) is the third most diagnosed cancer among men in Iran with approximately 4200 new cases in 2015. Considering the rapid growth of cancer diagnosis, this study aims to investigate the economic burden of PCa patients and their health-related quality of life (HRQoL) A retrospective survey was conducted on 500 registered patients to discover the pattern of care and distribution of patients in the main treatment categories. In the next step, a multi-center survey of the patients under treatment was conducted. The objective of this survey was to estimate direct medical costs (DMC), non-medical costs, and productivity losses for patients and family members. HRQoL was measured by the Functional Assessment of Cancer Therapy–Prostate questionnaire. Despite high age of patients (72±9.25 years), only 53.3% of them were retired or disabled. The largest proportion of patients (54.3%) received medicinal or surgical hormone therapy. Radical prostatectomy was the main treatment for 31.7% of patients, 10.2% received radiation therapy, and 3.8% underwent chemotherapy. DMC for incident population was approximately 12.5 million US dollars/year, and the highest average cost per capita belonged to chemotherapy patients. Unpredictably, productivity loss was nearly as much as direct cost. The mean score for HRQoL was 0.62±0.16 for all patients. Orchiectomy group had the lowest HRQoL score (0.55±0.16). Chemotherapy patients suffered the worst scores in the physical well-being subscale (0.47±0.24). Hormone therapy patients had the least scores in the prostate-specific subscale (0.50±0.18). The economic burden of PCa is estimated approximately 25.8 million US dollars per year for incident population. When we refer to the high proportion of patients diagnosed in advanced state of the disease and higher per capita cost for these patients, policy makers should promote screening strategies to control health care costs and to increase both life expectancy and HRQoL.