What question did this study set out to answer?

To estimate direct medical costs associated with localized prostate cancer diagnosis and treatment in South Africa.

February 9, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Costing the national clinical guidelines for prostate cancer control and management in South Africa: Public sector perspective

ETEvelyn ThsehlaUniversity of the Witwatersrand MKMariana KhozaUniversity of the Witwatersrand MBM K BoachieUniversity of the Witwatersrand

Key Points

To estimate direct medical costs associated with localized prostate cancer diagnosis and treatment in South Africa.
Estimated costs using a micro-costing approach from a payer's perspective.
Identified cost items from national clinical guidelines for prostate cancer.
Assessed cost data based on treatment options for low, intermediate, and high-risk patients.
Used 2022 unit costs and incidence data to calculate total costs for new cases.
Estimated total cost for treating 10,944 new prostate cancer cases in 2022 at ZAR2.1 billion.
Per patient costs ranged from ZAR7,265 to ZAR151,872, depending on risk category.
Total management costs were ZAR401.3 million for low-risk, ZAR371.1 million for intermediate-risk, and ZAR1.4 billion for high-risk prostate cancer.

Abstract

Background. Prostate cancer (PCa) is the second most common cancer worldwide and the sixth leading cause of cancer deaths in men. In South Africa (SA), PCa accounts for ~13% of male deaths. The direct medical costs associated with PCa diagnosis and treatment according to the national clinical guidelines for prostate cancer control and management are not documented. Objectives. To estimate the direct medical costs for localised PCa diagnosis and treatment according to the national clinical guidelines for prostate cancer control and management in SA. Methods. The direct medical costs for diagnosis and treatment of prostate cancer were estimated from the payer’s perspective using a micro- costing approach, with a time horizon of 12 months. Cost items were identified from the national PCa clinical guidelines and quantified according to the treatment options for low- (LRPCa), intermediate- (IRPCa) and high-risk (HRPCa) categories. Cost data were obtained from different government databases. The unit costs and PCa incidence data from 2022 were then used to estimate total costs for treating all new PCa cases. Total costs were calculated for each treatment method listed in the clinical guidelines according to PCa risk categories. Results. The total cost for treating 10 944 new PCa cases in 2022 was estimated at ZAR2.1 billion. Per patient costs ranged from ZAR7 265 to ZAR143 156 for LRPCa, ZAR8 926 to ZAR144 817 for IRPCa and ZAR14 874 to ZAR151 872 for HRPCa. The total cost for managing all patients with LRPCa, IRPCa and HRPCa were estimated at ZAR401.3 million, ZAR371.1 million and ZAR1.4 billion, respectively. Conclusion. This study estimated the cost for diagnosis and treatment of localised PCa according to national clinical guidelines for PCa control and management. The costs increased with each risk category of the cancer. The study highlights the need for policy-makers to increase early detection and management, to reduce the need for high-cost interventions.

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