Prevalence of Patients With Nonmetastatic Prostate Cancer on Androgen Deprivation Therapy in the United States

ObjectiveTo provide the first comprehensive assessment of the number of men exposed to continuous androgen deprivation therapy (ADT) in the nonmetastatic setting in the United States.MethodsWe assembled 2 point-prevalent cohorts on December 31, 2008: men aged 18-64 years enrolled in commercial health plans (MarketScan) and men aged ≥67 years enrolled in fee-for-service (FFS) Medicare (Medicare 5% sample). We identified men with nonmetastatic prostate cancer who were actively receiving continuous ADT (gonadotropin-releasing hormone agonists or bilateral orchiectomy) for at least 6 months on the point-prevalence date. The number of prevalent ADT users in the national commercially insured (45-64 years) and FFS Medicare (≥65 years) populations was extrapolated with person-level weights. Using age-specific prevalence estimates derived from the 2 data sources, the number of prevalent users in the entire U.S. male population aged ≥45 years was also estimated.ResultsWe estimate that 11,935 commercially insured men aged 45-64 years (95% confidence interval [CI], 11,310-12,561) and 115,468 FFS Medicare male beneficiaries aged ≥65 years (95% CI, 112,304-118,633) represented patients with nonmetastatic prostate cancer actively receiving continuous ADT for ≥6 months in the United States on December 31, 2008. Extrapolated to the total U.S. male population aged ≥45 years, this estimate was 188,916 (95% CI, 184,104-193,727).ConclusionOur findings suggest that a substantial number of men with nonmetastatic prostate cancer are managed with continuous ADT for ≥6 months during the course of their disease.