Managing XXXX by radical prostatectomy or watchful waiting: Cost analysis of a randomized trial (SPCG-4).

@entity1 @entity204 @entity263
OBJECTIVE: The cost of radical prostatectomy (RP) compared to watchful waiting (WW) has never been estimated in a randomized trial. The goal of this study was to estimate long-term total costs per @entity1 associated with RP and WW arising from inpatient and outpatient hospital care. MATERIAL AND METHODS: This investigation used the Scandinavian @entity263 Group Study Number 4 (SPCG-4) trial, comparing RP to WW, and included data from 212 @entity1 living in two counties in Sweden from 1989 to 1999 (105 randomized to WW and 107 to RP). All costs were included from randomization date until @entity204 or end of follow-up in July 2007. Resource use arising from inpatient and outpatient hospital costs was measured in physical units and multiplied by a unit cost to come up with a total cost per @entity1 . RESULTS: During a median follow-up of 12 years, the overall cost in the RP group was 34% higher (p < 0.01) than in the WW group, corresponding to    6123 in Sweden. The difference was driven almost exclusively by the cost of the surgical procedure. The cost difference between RP and WW was two times higher among @entity1 with low (2-6) than among those with high (7-10) Gleason score. CONCLUSION: In this economic evaluation of RP versus WW of @entity263 in a randomized study, RP was associated with 34% higher costs. This difference, attributed exclusively to the cost of the RP procedure, was not overcome during extended follow-up.
