GPs ‘more cost effective’ for prostate cancer aftercare

The healthcare system could save more than €760k over the next 10 years if survivors of prostate cancer were offered follow-up care with their GPs instead of hospital-based clinicians, according to research.

The study, by researchers at the National Cancer Registry Ireland (NCRI), said this model would be more cost effective and would not result in any adverse changes in aftercare.

After being treated for prostate cancer, sufferers have ongoing checks with a medical professional to see if the disease is returning and to monitor and manage any potential side-effects of the cancer treatment.

Traditionally, this aftercare is administered by specialist clinicians in a hospital.

The NCRI’s new study, published in the journal Supportive Care in Cancer, revealed specialist aftercare for this type of cancer is no longer “sustainable” here due to the country’s rising number of prostate cancer survivors. It suggests survivors should switch to GP follow-up sessions instead as it is a more viable option and will not adversely affect the quality of aftercare received.

“Identifying an efficient and sustainable strategy for prostate cancer follow-up care could help reduce the strain on Ireland’s health care budget,” said Dr Alison Pearce, lead researcher on the NCRI study.

“Economic models are always simplifications of reality, but our results suggest that moving prostate cancer follow-up to primary care should be considered in Ireland to improve efficiency and sustainability.”

NCRI health economists compared the costs of three strategies for prostate cancer follow-up. They looked at the European Association of Urology (EAU) guidelines, which recommend traditional follow-up by a hospital-based specialist, the National Institute of Health Care Excellence (NICE) guidelines, which recommend well patients are followed up on by GPs after two years, and they looked at the current practice in Ireland.

The results showed that the GP-based follow-up, consistent with the NICE guidelines, is the most cost efficient strategy for prostate cancer follow-up.

“Current practice is least cost efficient, because people end up seeing both their hospital specialist and their GP,” said Dr Pearce..

If all those diagnosed with prostate cancer in 2013 were offered follow-up according to the NICE guidelines for the next 10 years, the Irish health care system could save more than €760k.