Clinical characteristics,treatment pattern,and medical costs associated with metastatic castration-resistant prostate cancer in Chinese tertiary care hospital settings

Objectives: To describe the clinical characteristics, treatment pattern, and medical costs associated with metastatic castration-resistant prostate cancer (mCRPC) in Chinese patients.

Methods: This retrospective study identified a group of patients with newly-developed mCRPC from 2012 to 2016 to extract information from their medical and billing records in two tertiary care hospitals. Descriptive statistical methods were used to summarize patient clinical characteristics, treatment pattern, and monthly medical costs. Conventional regression analyses explored the predictors for the utilization of chemotherapy and monthly medical costs.

Results: Seventy-eight identified mCRPC patients were characterized with a high proportion of stage IV tumors at diagnosis of prostate cancer (75.0%) and high prevalence of bone metastasis (91.0%). Sixty-six percent of the identified patients only received one treatment episode. Among the patients receiving the first treatment episode, hormone therapy, chemotherapy, and best supportive care (BSC) accounted for 75.7%, 21.4%, and 2.9%, respectively; the previous orchiectomy was significantly associated with chemotherapy (odds ratio?=?5.325, p?=?0.034); and chemotherapy was associated with comparable drug costs and higher non-drug costs (coefficient?=?0.657, p?=?0.056) when compared to hormone therapy after the adjustment of patient characteristics.

Conclusions: Chinese mCRPC patients were characterized with delayed diagnosis of prostate cancer and high prevalence of bone metastasis. The treatment options for mCRPC were limited in Chinese patients as the conventional hormone therapy was still heavily used after the development of mCRPC. The medical costs associated with mCRPC were mainly driven by chemotherapy in Chinese patients.