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Journal of Robotic Surgery
Published in: Journal of Robotic Surgery 6/2021

01-12-2021 | Prostate Cancer | Original Article

Cost-effectiveness analysis of robotic-assisted versus retropubic radical prostatectomy: a single cancer center experience

Authors: Renato Almeida Rosa de Oliveira, Gustavo Cardoso Guimarães, Thiago Camelo Mourão, Ricardo de Lima Favaretto, Thiago Borges Marques Santana, Ademar Lopes, Stenio de Cassio Zequi

Published in: Journal of Robotic Surgery | Issue 6/2021

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Abstract

Prostate cancer (PCa) treatment has been greatly impacted by the robotic surgery. The economics literature about PCa is scarce. We aim to carry-out cost-effectiveness and cost-utility analyses of the robotic-assisted radical prostatectomy (RALP) using the “time-driven activity-based cost” methodology. Patients who underwent radical prostatectomy in 2013 were retrospectively analyzed in a cancer center over a 5-year period. Fifty-six patients underwent RALP and 149 patients underwent retropubic radical prostatectomy (RRP). The amounts were subject to a 5% discount as correction of monetary value considering time elapsed. Calculation of the Incremental Cost-Effectiveness Ratios (ICER) related to events avoided and the Incremental Cost-Utility Ratio (ICUR) related to “QALY saved” were performed. QALY was performed using values of utility and “disutility” weights from the “Cost-Effectiveness Analysis Registry”. Hypothetical cohorts were simulated with 1000 patients in each group, based on the treatment outcomes. Total and average costs were R$1,903,671.93, and R$12,776.32 for the RRP group, and R$1,373,987.26, and R$24,535.49 for the RALP group, respectively. The costs to treat the hypothetical cohorts were R$10,010,582.35 for RRP, and R$19,224,195.90 for RALP. ICER calculation evidenced R$9,213,613.55 of difference between groups. ICUR was R$ 22,690.83 per QALY saved. Limitations were the lack of cost-effectiveness analyses related to re-hospitalization rates and complications, single center perspective, and currency-translation differences. Medical fees were not included. RALP showed advantages in cost-effectiveness and cost-utility over RRP in the long term. Despite the increased costs to the introduction of robotic technology, its adoption should be encouraged due to the gains.
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Metadata
Title
Cost-effectiveness analysis of robotic-assisted versus retropubic radical prostatectomy: a single cancer center experience
Authors
Renato Almeida Rosa de Oliveira
Gustavo Cardoso Guimarães
Thiago Camelo Mourão
Ricardo de Lima Favaretto
Thiago Borges Marques Santana
Ademar Lopes
Stenio de Cassio Zequi
Publication date
01-12-2021
Publisher
Springer London
Published in
Journal of Robotic Surgery / Issue 6/2021
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-020-01179-z

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