{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:29:48Z","timestamp":1793723388349,"version":"4.6.1"},"reference-count":25,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"2","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>External beam radiation therapy (EBRT) and radical prostatectomy (RP) are definitive options for patients with localized or locally advanced prostate cancer (LPC). Limited evidence exists on the post-treatment economic burden in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This real-world analysis investigated healthcare costs among Medicare beneficiaries with LPC who received EBRT or RP as initial definitive treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective, longitudinal cohort study using Surveillance, Epidemiology, and End Results (SEER)\u2013Medicare database. Included were Medicare Fee-For-Service beneficiaries newly diagnosed with LPC at the age of \u226565 years during 2012-2019 and received either EBRT or RP as an initial definitive therapy. After the initial therapy, all-cause and prostate cancer\u2013related costs were summarized and stratified by the earliest observed definitive therapy (RP vs EBRT) and the National Comprehensive Cancer Network risk classification (low\/intermediate-risk [LIR-LPC] vs high-risk [HR-LPC]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 17\u2009066 LPC patients treated with EBRT, 60% (N\u2009=10\u202f321) had LIR-LPC and 40% (N\u2009=\u20096745) had HR-LPC. During the follow-up, the mean per-person-per-year all-cause cost was $9837 higher in the HR-LPC cohort than the LIR-LPC cohort ($34\u202f441 vs $24\u202f604;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Of the 9479 patients treated with RP, 43% (N\u2009=\u20094120) had LIR-LPC and 57% (N\u2009=\u20095359) had HR-LPC. The mean per-person-per-year all-cause cost during follow-up was $6829 higher in the HR-LPC cohort than the LIR-LPC cohort ($23\u202f820 vs $16\u202f991;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Across all cohorts, the largest all-cause healthcare cost category was outpatient, followed by inpatient and prescription drug.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This real-world study on healthcare costs in patients with LPC treated with EBRT or RP showed HR-LPC is associated with significant incremental economic burden relative to LIR-LPC. The findings highlight the current unmet need for more cost-effective treatment strategies for HR-LPC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.163569","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:23:57Z","timestamp":1785338637000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Economic Outcomes of Patients with Localized Prostate Cancer Treated with External Beam Radiation Therapy or Radical Prostatectomy"],"prefix":"10.36469","volume":"13","author":[{"given":"Lawrence","family":"Karsh","sequence":"first","affiliation":[{"name":"AdventHealth Urology, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Du","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"He","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Shore","sequence":"additional","affiliation":[{"name":"Carolina Urologic Research Center, Myrtle Beach, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kruti","family":"Joshi","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"4","key":"ref1","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/j.juro.2018.01.002","article-title":"Clinically localized prostate cancer: AUA\/ASTRO\/SUO guideline. 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