A retrospective study was performed on the cost-effectiveness of treatment for advanced
prostate cancer metastatic to bone. Patients (n = 29) recruited into the trans Canada trial at the Cross
Cancer Institute, Edmonton and randomized to treatment with
Metastron (strontium-89 chloride) (n = 14) or placebo (n = 15) after local field irradiation
therapy for
pain palliation were studied over their entire survival time. Estimates were made of the direct costs of treatment, i.e. drugs (
analgesics and hormonal agents) and external
radiotherapy, and the indirect costs (investigations, outpatient visits and inpatient days, either total or for tertiary care) based on records from the referring hospital, the
cancer clinic and any hospitals to which the patients may subsequently have been referred. Meaningful differences were apparent between the two groups in direct costs with the group receiving
Metastron showing a reduction over the entire survival time of Can$ 1,720/person compared with placebo; it should be noted that in this analysis neither the costs of the
Metastron, nor of the initial
radiotherapy, have been included. The
Metastron group also showed a reduction in costs of hospitalization for tertiary care of Can$ 5,696/person, though the total cost of hospitalization was similar in the two groups. These results suggest that treatment with
Metastron can bring about reductions in management costs for patients with advanced
prostate cancer and, coupled with the findings of the Trans Canada trial on the improvement in quality of life for patients given
Metastron, they add financial support to the clinical rationale for the use of
Metastron for the
palliative treatment of patients with bone
metastases resulting from
prostate cancer.