{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:32:15Z","timestamp":1787725935394,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01 CA279746"],"award-info":[{"award-number":["R01 CA279746"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32 CA180984"],"award-info":[{"award-number":["T32 CA180984"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Men with newly diagnosed prostate cancer often appropriately elect for either immediate treatment or conservative management. The out\u2010of\u2010pocket costs they face vary by management strategy, with immediate treatment often superseding those of conservative management, potentially influencing patient decisions. We estimated the anticipated out\u2010of\u2010pocket costs that commercially insured men with newly diagnosed prostate cancer face and measured their association with immediate treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From MarketScan, we identified men with newly diagnosed prostate cancer from 2010\u20132020. Separately, using actual out\u2010of\u2010pocket costs (summing deductible, copay, coinsurance) among patients undergoing arthroscopic meniscal repair (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009383,187), we derived regression coefficients for patient\u2010level variables (e.g., health plan type) that inform their financial liability. We applied these coefficients to men with prostate cancer and estimated their predicted out\u2010of\u2010pocket costs, our main exposure. We sorted patients into quartiles and used logistic regression to calculate adjusted probabilities of immediate treatment (versus conservative management).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 58,206 men with prostate cancer and rank ordered them by predicted out\u2010of\u2010pocket cost. Approximately 12% of men had a predicted out\u2010of\u2010pocket cost of zero, and among those with non\u2010zero cost sharing, the median out\u2010of\u2010pocket cost was $350 (IQR: $275, $486). Across quartiles of predicted out\u2010of\u2010pocket costs, adjusted percentages of immediate treatment were in a narrow range between 77.8% (95% CI: 76.8%, 78.8%) for Quartile 1% and 78.6% (95% CI: 77.7%, 79.5%) for Quartile 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among commercially insured men with prostate cancer, predicted out\u2010of\u2010pocket costs varied substantially. However, the choice of management, immediate treatment or conservative management, appears insensitive (i.e., inelastic) to patient anticipated financial liability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71184","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:36:38Z","timestamp":1756460198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anticipated Out\u2010Of\u2010Pocket Costs and Prostate Cancer Management Among Men With Commercial Insurance"],"prefix":"10.1002","volume":"14","author":[{"given":"Sarah","family":"Leick","sequence":"first","affiliation":[{"name":"Department of Urology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1651-317X","authenticated-orcid":false,"given":"Addison","family":"Shay","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0103-5734","authenticated-orcid":false,"given":"Paula","family":"Guro","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preeti","family":"Chachlani","sequence":"additional","affiliation":[{"name":"Department of Urology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Oerline","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Dall","sequence":"additional","affiliation":[{"name":"Department of Urology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawson C.","family":"Hill","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Maganty","sequence":"additional","affiliation":[{"name":"Department of Urology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahakn B.","family":"Shahinian","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent K.","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9772-1415","authenticated-orcid":false,"given":"Arnav","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research, Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0019"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26491"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002758"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2016.09.007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1212321"},{"key":"e_1_2_9_7_1","unstructured":"M.Chernew P.Joseph P.Newhouse et\u00a0al. \u201cWhat Does the RAND Health Insurance Experiment Tell us About the Impact of Patient Cost Sharing on Health Outcomes? 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