Would Prostate Cancer Treatment Cost You Fortune?

It is quite challenging to afford prostate cancer treatment while living in developed countries like the United States. The prostate, a crucial gland in men's bodies, is responsible for providing sperm with its protective substance. Despite its proximity to the urethra and testis, the prostate tirelessly performs its functions throughout a man's life.

However, as men reach the age of 50, they may encounter issues with their prostate gland, and some may even develop prostate cancer.  Prostate cancer, the second most common in men, affects a significant number of individuals, with more than 1 million cases reported worldwide every single year. 

What Are the Known Treatments for Prostate Cancer and their Costs?

First, people diagnosed with Prostate cancer should know if it is localized or not. When prostate cancer cells have exited the membrane of the prostate then we are talking about metastatic prostate cancer. 

Kinds of treatment vary according to the clinical decision of urologists and oncologists who are the major medical specialties dealing with prostate cancer patients.

Prostatectomy

The first and most established treatment for prostate cancer is surgical excision of the prostate in an open surgery procedure known as prostatectomy. 

This costs about $17,000 USD when performed in America and it can be anywhere between $5,000 USD and $20,000 USD when performed in Europe. This has to do with the type of prostatectomy (classic open operation or robotic-assisted operation).

Hormone Therapy

Hormone therapy has a great effect in slowing down the spread of cancer cells using drugs like LHRH-analogues. These are substances like leuprolide, triptorelin and others that are injected intramuscularly and have various costs. 

European patients pay about $15,000 per year for their treatment, while the same treatment in America could be close to $18,000 per year.

Radiation Therapy

Interventional radiologists are the ones that can administer radiation to the prostate area locally to erase the cancer cells and stop their proliferation within the prostate gland. 

The average cost of this therapy is about $9,000 in Europe and could cost more than $20,000 in the United States of America.

Chemotherapy

Some metastatic or aggressive prostate cancers may need to proceed to chemotherapy. This is performed with drug substances administered intravenously, like Docetaxel or Cabazitaxel. 

Both are extremely expensive drugs administered only in inpatient facilities. They cost about $12,000 in Europe and about $15,000 in the United States, excluding the hospitalization costs that could vary.

Metastatic Prostate Cancer

Many of the cases of prostate cancer are passing through the metastatic phase. That means some cancer cells exit the prostate gland and can enter the bloodstream to invade lymph nodes or other organs like lungs, bones, or the liver.

This is when some new drugs are administered to halt the symptoms of metastatic prostate cancer and increase the life expectancy of patients. These drugs are abiraterone, enzalutamide, and apalutamide. 

They all have indications of metastatic prostate cancer in Europe and America. Let's see how they work and what the average cost of treatment is for each one of these substances.

Abiraterone

It is known and marketed under the commercial name of Zytiga, a drug administered orally once a day for 60 days of treatment. 

This drug is only prescribed to patients who have already gone through one of the basic treatments for prostate cancer and are diagnosed with metastatic prostate cancer.

The cost of this medicine is very different in Europe and America. On average, the Abiraterone price in Europe is about $36,600 per year. However, the same treatment in the United States is more expensive, getting up to $9,000 per month. If we compare Abiraterone price in USA, UK, Malaysia, Philippines & other countries then India is winning this race.

Lately, we have seen generic abiraterone drugs coming to the market that are lowering the treatment price for metastatic prostate cancer patients. For instance, there are generic abiraterone 250 mg drugs sold in India at very economical price.

Enzalutamide

Another promising drug in the treatment of metastatic prostate cancer is enzalutamide, marketed under the brand name Xtandi. 

It is an oral capsule for a 60-day treatment and has various costs according to the geography of the patient's life. The price of enzalutamide in the European area is close to $3,522 per month. 

On the other hand, the same treatment in the United States could cost as much as $160,000 or $180,000 per year, which is an all-time high for Xtandi around the world. There are also generic drugs marketed in India, containing Enzalutamide 40 mg that cost only 5% of brand. 

Apalutamide

One of the newest and most promising therapies in metastatic prostate cancer is Apalutamide. It is marketed under the commercial name Erleada and is the most selective Androgen receptor inhibitor in the world. 

With an average cost in the United States that is close to $15,000 for monthly therapy.

Costs for European patients are significantly lower, being $2,600 per month. 

The existence of these three substances has increased the overall life expectancy of metastatic prostate cancer patients. Additionally, they have dramatically improved their quality of life and controlled the cancer symptoms.

Why Are There Differences in The Prices Between Europe and America?

As mentioned before, there are huge differences in the prices of molecules used in metastatic prostate cancer treatment between Europe and America. 

That has to do with the reimburser in both areas. In Europe public health systems are the major payers for these treatments and therefore they ask for discounts from major pharmaceutical manufacturers.

On the other hand, the United States has no public health system. The private health insurers in America negotiate prices in higher levels and that is why the treatment for metastatic prostate cancer in the United States is three or four times more expensive than in Europe.

Hidden Costs in Metastatic Prostate Treatment

Drug costs may be the largest parts of expenditures for metastatic prostate cancer patients, but they are not the only ones. 

Here is a comprehensive list of potential costs for these patients that have to do with the successful treatment of their disease:

• Hospitalization Costs

• Palliative Care

• Personal Nurse-Assistant Costs

• Use of other drugs that ease symptoms and side effects of Enzalutamide, Abiraterone, or Apalutamide

• Doctors' visits

• Ultrasound, CT-scan, PET-scan and blood tests costs

As we understand, treating metastatic prostate cancer is a great expense for health systems in all geographies. Most patients should be ready to pay out of pocket for many of these expenses to ensure they receive timely and proper treatment for metastatic prostate cancer. 

This places a huge burden on patient compliance and is a matter of dignity for most societies.

As a result, proper screening for prostate cancer, especially in men over 50 years old, could significantly lower the cost of treatment and increase life expectancy and overall health levels. 

It is also true that people can lower the costs of treatment for prostate cancer when they choose to use generic drugs. The use of generic abiraterone or enzalutamide in the metastatic prostate cancer, offers a prolongation of overall survival and has no difference between the prototype drugs and the generic ones.

As a result, it is a wise choice to use generic drugs (in cooperation with your physician) to ensure compliance with any local regulations and cut the budget you pay out of pocket for these expensive therapies.

Conclusion

Today prostate cancer patients have multiple reasons to feel optimistic. There are plenty of therapy options and at the same time pharmaceutical substances cost lower than they used to. 

The ample use of generic drugs gives patients worldwide the chance to have their therapy at the best affordable price without the need to worry about its disruption. Most patients can be sure they will get the best out of the medical science and feel a lot better about dealing with their symptoms.