Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost

Area of Science:

• Urology
• Health Economics
• Medical Practice Trends

Background:

• Prostate biopsies are crucial for diagnosing prostate cancer.
• Sedation during procedures can enhance patient comfort but may increase costs.
• Understanding trends in sedation use is vital for healthcare providers and patients.

Purpose of the Study:

• To analyze national trends in sedation use for prostate biopsies.
• To identify predictors associated with sedation during these procedures.
• To examine patient costs related to sedation in prostate biopsies.

Main Methods:

• Retrospective cohort study using the Merative Marketscan Database (2016-2021).
• Identified prostate biopsies using CPT codes; analyzed biopsy type, anesthesia, comorbidities, and MRI use via ICD-10 codes.
• Multivariable logistic regression assessed predictors; out-of-pocket costs were calculated and adjusted to 2021 dollars.

Main Results:

• Proportion of sedated prostate biopsies increased from 15.6% (2016) to 25.5% (2021).
• Saturation biopsies (OR=9.02), prior biopsy history (OR=1.39), and MRI-guided biopsies (OR=1.98) were significantly associated with higher sedation likelihood.
• Out-of-pocket costs in 2021: $663 for sedated vs. $489 for non-sedated biopsies.

Conclusions:

• Sedation use in prostate biopsies is increasing, paralleled by rising patient expenses.
• Specific biopsy types (saturation, MRI-guided) and patient history (prior biopsy) are key predictors for sedation.
• Balancing patient comfort with cost and accessibility is essential given evolving biopsy practices.