Canadian cost comparison of different forms of androgen ablative therapies prior and during the castration-resistant prostate cancer.
Bibliographic record
Abstract
e16029 Background: Medical or surgical castration are the treatments of choice for hormone-sensitive prostate cancer with a high-risk of disease recurrence or progression. In addition, androgen ablation (ADT) maintenance is recommended during the castration-resistant prostate cancer phase. The objective of this study was to perform a cost comparison of different ADT forms, including luteinizing hormone releasing hormone agonists (LHRHa) medications and surgical castration, given prior to and during the castration-resistant prostate cancer (CRPC) phase. Methods: A Markov model was developed in order to simulate survival since ADT initiation and associated costs as per Quebec’s public healthcare system, in patients with a high-risk of disease recurrence or progression. The model includes recently approved additional lines of treatment given after docetaxel (i.e. abiraterone and cabazitaxel). Survival was based on clinical trial results and clinical practice guidelines found through a literature review. Costs are in 2014 Canadian dollars ($). Results: The mean per patient ADT cost in CRPC over an average period of 28.1 months was estimated at: $1,413 for surgical castration, $8,346 for Leuprolide (Eligard), $8,514 for Triptorelin (Trelstar), $9,891 for Buserelin (Suprefact Depot), $10,032 Leuprolide (Lupron Depot), and $10,172 for Goserelin (Zoladex). The corresponding values in the period prior to CRPC, over 75.1 months, were: $1,413, $22,305, $22,755, $26,435, $26,811 and $27,186, respectively. For each annual Canadian cohort of 4,000 CRPC patients, the total cost of ADT during the CRPC phase was estimated at $5.6 million for surgical castration, and between $33.4 and $40.7 million for LHRHa therapy. Over the period prior to CRPC, the total cost for surgical castration remained the same and was between $89.2 and $108.8 million for LHRHa therapy. Conclusions: Our study estimates the costs associated with the use of different ADT prior and over the CRPC phase. Increasing the use of least costly forms of ADT will result in potential cost savings.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".