Sophie Bouvet, Sihame Chkair, Jean Pierre Daurès, Sarah Kabani, Thierry Chevallier, Eric Lechevallier, Stéphane Droupy
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引用次数: 0
Abstract
Background: The economic impact of RARP versus laparoscopic (LRP) or open surgical radical prostatectomy (OSRP) is unclear. The objective is to estimate and compare the total cost of radical prostatectomy with and without robot assistance from the French establishment perspective. This estimate can assess the cost benefit of robotic-assisted radical prostatectomy (RARP) and determine who should pay.
Methods: A micro-costing bottom-up time-and-motion approach was used based on 2018 prices (€). In public hospitals, observed data for OSRP and RARP was used; in private hospitals, expert opinions were sought from clinicians for RARP and LRP. Average costs, costs per minute of surgery and costs per expenditure were compared between techniques. A sensitivity analysis accounted for variability in cost of personnel and amortized cost of Da Vinci robot.
Results: The average estimated cost of surgery was 4683.35€ [95% CI=2900; 6467.2] more for RARP versus LRP in private clinics, and 3744€ [95% CI=3525; 3963] for RARP versus OSRP in public hospital. Recovery costs were equivalent between techniques (112.9€ for RARP and LRP in private and 46.1€ [95% CI=31.8; 60.4] for OSRP and 47.8€ [95% CI=39.1; 56.5] for RARP in public hospital). The sensitivity analysis confirmed the extra cost for RARP versus LRP or OSRP.
Conclusions: Depending on the surgery compared (OSRP or LRP), institute type (public or private) and data source (observed or expert opinion), the extra cost of the robot varied from 3744€ to 4683.35€. The amortized cost of the robot and its specific materials were the main elements of the difference.
Trial registration: This comparative, multi-centre economic study combines one secondary objective from the RoboProstate study (NCT01577836) and part 1 of the OptiPRobot study (IRB #19.07.03).
期刊介绍：
Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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