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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
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Cost-utility analysis on robot-assisted and laparoscopic prostatectomy based on long-term functional outcomes
Melanie A Lindenberg1,2, Valesca P Retèl1,2, Henk G van der Poel3
1Division of Psychosocial Research and Epidemiology, Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Scientific Reports
|May 10, 2022
Summary
Robot-Assisted Radical Prostatectomy (RARP) offers improved urinary function and is cost-effective compared to Laparoscopic RP (LRP). Centralizing RARP procedures further enhances its value, supporting full reimbursement.
Area of Science:
- Urology
- Health Economics
- Surgical Oncology
Background:
- Robot-Assisted Radical Prostatectomy (RARP) is a standard prostate cancer treatment, but its added value remains debated.
- Previous studies suggest potential benefits in long-term urinary functioning.
Purpose of the Study:
- To evaluate the cost-effectiveness of RARP compared to Laparoscopic RP (LRP) for prostate cancer treatment.
- To analyze costs and quality-adjusted life years (QALYs) from a Dutch societal perspective over 7 years.
Main Methods:
- A decision tree model was developed using data from a large retrospective Dutch study.
- Costs included intervention, additional care, and surgeon-reported ergonomic issues.
- Probabilistic, one-way sensitivity, and scenario analyses were performed.
Main Results:
- RARP intervention costs were €9964 vs €7253 for LRP; total costs were €12,078 vs €10,049.
- RARP yielded higher QALYs (6.17 vs 6.11), with an ICUR of €34,206/QALY gained.
- Centralizing RARP (>150 cases/year) reduced costs to €10,377 and ICUR to €3495/QALY gained.
Conclusions:
- RARP is cost-effective compared to LRP for prostate cancer treatment.
- Findings support full reimbursement for RARP, particularly when procedures are centralized.
