Racial differences in the cost of treating men with early-stage prostate cancer

OBJECTIVE: To compare the cost and resource utilization in the evaluation, treatment, and 6-month follow-up of African-American and White men undergoi ng either external beam radiation therapy (XRT) or radical prostatectomy (R B) for early-stage prostate cancer. DESIGN: Retrospective analysis of cost and resource utilization data from e ncrypted patient-specific hospital inpatient, hospital outpatient, and phys ician/supplier data files. SETTING: National Medicare claims data from 1993 through 1996. PARTICIPANTS: A random 5% national sample of Medicare beneficiaries from th e Health Care Financing Administration Public Use Files for 1993 through 19 96. MEASUREMENTS: Inpatient, outpatient, and physician/ supplier Medicare costs . RESULTS: African-American men undergoing RP for early-stage prostate cancer had significantly higher costs ($21,878 vs $18,786, P < .0001) than did Wh ite men. Most of the difference occurred in the inpatient setting. African- American men undergoing XRT had significantly greater costs ($18,131 vs $15 ,734, P < .0001) than did White men. Most of this difference was generated by longer duration of XRT treatments. CONCLUSIONS: In early-stage prostate cancer, charges for RE and XRT in Afri can-American men are higher when compared with those for White men.