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Título

COST-EFFECTIVENESS ANALYSIS OF PROSTATE CANCER TREATMENT IN GOIAS: ARE THESE DATA ARE DIFFERENT FROM NATIONAL ONES? AN ECOLOGICAL STUDY

Resumo

INTRODUCTION: The estimated number of new cases of prostate cancer in Brazil, for the three-year period from 2023 to 2025, is 71.730, corresponding to an estimated risk of 67,86 new cases per 100.000 men. Goias is the most populous state with the highest gross domestic product in the brazilian Midwest, being a hub and reference for other states in the region. The estimate for the state in 2023 is 2500 cases, 3.5% of cases in the country. Our study aims to describe the number of cases of prostate cancer in Brazil and in Goias, the costs related to treatment and hospitalization, the average length of stay and the mortality rate in the state. METHODS: This was an ecological study, descriptive, analytic and retrospective study analysing the data reported between January 2010 and December 2022. RESULTS: A total of 93.759 surgeries were performed for prostate cancer in Brazil. The cost of hospital procedures in Goias was $2.695.873,66 and, in Brazil, was $25.641.382,80. The cost per surgery to the public health system in Goias was higher than Brazilian average, with $4.003,85 in state and $2.500,20 in the country. The length of hospital stay after surgery for prostate cancer in Goias was 3,6 days and in Brazil was 5,4 days. DISCUSSION: In Goias, we noticed that the average cost of surgery per patient was higher than the national average. This may be due to the presence of few centers in Goias specialized in minimally invasive surgery for prostate cancer, which lead to increased surgical costs. In addition, many surgical instruments necessary for prostate cancer surgery need to be imported from other states, which can also influence the increase in surgical costs. In the other hand, the length of hospital stay was lower in Goiás, which may lead to believe that in the state the most favorable disease is selected for surgical treatment. Other possibilities such as the quality of postoperative care, the experience of surgeons and the choice of patients with fewer comorbidities can directly interfere with this result. CONCLUSION: The average cost per surgery in Goias is substantially higher than the national average, but it has a lower average hospital stay. This may translate the profile of patients with more indolent disease, despite the higher cost involved with surgical materials.