Transperineal prostate biopsy under local vs general anaesthesia: a cost-effectiveness analysis

Area of Science:

• Urology
• Health Economics
• Oncology

Background:

• Transperineal prostate biopsy (TPB) is a key diagnostic tool for prostate cancer.
• The choice of anaesthetic (local vs. general) impacts procedure costs and patient recovery.
• Estimating the cost-effectiveness of different anaesthetic approaches for TPB is crucial for healthcare resource allocation.

Purpose of the Study:

• To compare the cost-effectiveness of local anaesthetic (LA) TPB versus general anaesthetic (GA) TPB.
• To evaluate costs from both hospital/health system and societal perspectives.
• To assess the impact on cancer detection rates and patient return-to-work timelines.

Main Methods:

• A prospective pilot study included 80 patients undergoing LA or GA TPB based on preference.
• Cost-effectiveness analysis used a decision tree model, incorporating cancer detection, perioperative factors, and return-to-work data.
• Economic modeling included costs for consumables, devices, and personnel, with sensitivity analyses performed.

Main Results:

• Clinical parameters and cancer detection rates were similar between LA and GA TPB groups.
• LA TPB resulted in significantly shorter procedure and recovery durations.
• LA TPB demonstrated substantial cost savings (~AU$959 from a hospital perspective and ~AU$1639 from a societal perspective).

Conclusions:

• Local anaesthetic transperineal prostate biopsy is a cost-saving strategy for healthcare systems and society.
• The LA approach does not compromise the diagnostic accuracy of TPB.
• Implementing LA TPB can lead to improved efficiency and reduced economic burden without affecting clinical outcomes.