INTRODUCTION:
Prostate cancer (PCa) is the second most common cancer worldwide and the sixth leading cause of cancer deaths in men1. In South Africa (SA), PCa accounts for ~13% of male deaths2. The direct medical costs associated with PCa diagnosis and treatment according to the national clinical guidelines are not documented. The aim of this study is to estimate the direct medical costs for managing localised PCa in SA. Methods. The direct medical costs for diagnosis and treatment of prostate cancer were estimated from the public sector 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 and ZAR143 156 for LRPCa, ZAR8 926 and ZAR144 817 for IRPCa and ZAR14 874 and 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.