The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques

The Journal of Urology
Yair LotanMatthew T Gettman

Abstract

We evaluated the costs components of laparoscopic (LRP) and robot assisted prostatectomy (RAP), and compared their costs to those of open radical retropubic prostatectomy (RRP). A model was created using commercially available software to compare the costs of treatment with LRP, RAP or RRP. Hospital costs were obtained from a large county hospital. A literature search was performed to determine typical (average) robot costs, length of stay and operative time for RRP, LRP and RAP. We limited our analysis to mature series and included only the most recent efforts. The cost of the robot was estimated at 1,200,000 dollars with a 100,000 dollars yearly maintenance contract. It was assumed that the robot would be used across specialities for a total of 300 cases yearly in a 7-year period. We performed a series of 1 and 2-way sensitivity analyses to evaluate the costs of LRP, RAP and RRP, while varying robot costs, the number of robotic cases, hospital length of stay, operative time and cost of laparoscopic/robotic equipment. RRP was the most cost-effective approach with a cost advantage of 487 dollars and 1,726 dollars over LRP and RAP, respectively. If we excluded the initial cost of purchasing a robot, the cost difference between R...Continue Reading

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