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Cost comparison of curative therapies for localized prostate cancer in Japan: a single-institution experience

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Abstract

Purpose

In addition to open surgery, curative therapies for prostate cancer now include endoscopic surgery and radiation therapies. Because of the expansion and subdivision of treatment methods for prostate cancer, the medical fee point schedule in Japan was revised in fiscal year 2006. We examined changes in medical income and expenditure after this revision of the medical fee system.

Materials and methods

We studied income and expenditure, after institution of the new medical fee schedule, for the five types of therapies for prostate cancer performed at our hospital: two surgical therapies (radical retropubic prostatectomy and laparoscopic prostatectomy) and three radiation therapies (three-dimensional conformal radiation therapy, 192Ir high-dose-rate brachytherapy, and 125I low-dose-rate brachytherapy).

Results

Low-dose-rate brachytherapy was found to be associated with a profit of yy199 per patient. Laparoscopic prostatectomy, a highly advanced medical treatment that the fee revision changed from a partially insured to an insured procedure, yielded a profit of yy75 672 per patient. However, high-dose-rate brachytherapy was associated with a loss of yy654 016 per patient.

Conclusion

Given the loss in hospital income per patient undergoing high-dose-rate brachytherapy, the medical fee point system for this procedure should be reassessed.

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Authors and Affiliations

  1. Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, 228-8555, Japan

    Takefumi Satoh, Kazumasa Matsumoto, Ken-ichi Tabata, Masatsugu Iwamura, Masaki Kimura, Satoru Minamida, Hideyuki Yamashita, Daisuke Matsuda & Shiro Baba

  2. Department of Radiology, Kitasato University School of Medicine, Sagamihara, Japan

    Hiromichi Ishiyama, Masashi Kitano, Shouko Kotani, Yuzuru Niibe & Kazushige Hayakawa

  3. Division of Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan

    Mineko Uemae

Authors
  1. Takefumi Satoh
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  2. Hiromichi Ishiyama
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  3. Kazumasa Matsumoto
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  4. Ken-ichi Tabata
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  5. Masashi Kitano
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  6. Masatsugu Iwamura
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  7. Masaki Kimura
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  8. Satoru Minamida
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  9. Hideyuki Yamashita
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  10. Daisuke Matsuda
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  11. Shouko Kotani
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  12. Yuzuru Niibe
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  13. Mineko Uemae
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  14. Kazushige Hayakawa
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  15. Shiro Baba
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Corresponding author

Correspondence to Takefumi Satoh.

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Satoh, T., Ishiyama, H., Matsumoto, K. et al. Cost comparison of curative therapies for localized prostate cancer in Japan: a single-institution experience. Jpn J Radiol 27, 348–354 (2009). https://doi.org/10.1007/s11604-009-0356-x

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  • DOI: https://doi.org/10.1007/s11604-009-0356-x

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