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Health Economic Ana...
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Forsmark, A.Nordic Health Economics AB
(author)
Health Economic Analysis of Open and Robot-assisted Laparoscopic Surgery for Prostate Cancer Within the Prospective Multicentre LAPPRO Trial
- Article/chapterEnglish2018
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LIBRIS-ID:oai:gup.ub.gu.se/274666
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https://gup.ub.gu.se/publication/274666URI
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https://doi.org/10.1016/j.eururo.2018.07.038DOI
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https://lup.lub.lu.se/record/2af430c4-14d1-4744-932d-1ce78691e320URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:139593475URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: The rapid adoption of robot-assisted laparoscopy in radical prostatectomy has preceded data regarding associated costs. Qualitative evidence regarding cost outcomes is lacking. Objective: This study assessed how costs were affected by robot-assisted laparoscopic prostatectomy (RALP) compared with open surgery. Design, setting, and participants: Cost analysis was based on the dataset of the LAPPRO (Laparoscopic Prostatectomy Robot Open) clinical trial, which is a prospective controlled, nonrandomised trial of patients who underwent prostatectomy at 14 centres in Sweden between September 2008 and November 2011. Currently, data are available from a follow-up period of 24 mo. Intervention: In the LAPPRO trial, RALP was compared with radical retropubic prostatectomy (RRP). Outcome measurements and statistical analysis: Costs per surgical technique were assessed based on resource variable data from the LAPPRO database. The calculation of average costs was based on mean values; Swedish currency was converted to purchasing power parity US dollar (PPP$). All tests were two-tailed and conducted at alpha = 0.05 significance level. Results and limitations: The cost analysis comprised 2638 men. Based on the LAPPRO trial data, RALP was associated with an increased cost/procedure of PPP$ 3837 (95% confidence interval: 2747-4928) compared with RRP. The result was sensitive to variations in caseload. Main drivers of overall cost were robotic system cost, operation time, length of stay, and sick leave. Limitations of the study include the uneven distribution between RALP and RRP regarding procedures in public/for-profit hospitals and surgeon/centre procedural volume. Conclusions: Based on the LAPPRO trial data, this study showed that RALP was associated with an increased cost compared with RRP in Swedish health care. There are many factors influencing the costs, making the absolute result dependent on the specific setting. However, by identifying the main cost drivers and/or most influential parameters, the study provides support for informed decisions and predictions. Patient summary: In this study, we looked at the cost outcome when performing prostatectomies by robot-assisted laparoscopic technique compared with open surgery in Sweden. We found that the robot-assisted procedure was associated with a higher mean cost. (C) 2018 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.
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Gehrman, Jacob,1986University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xgehja
(author)
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Angenete, Eva,1972University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xangee
(author)
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Bjartell, AndersLund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kir-abj
(author)
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Bjorholt, I.Nordic Health Economics AB
(author)
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Carlsson, S.Karolinska Institutet,Karolinska Institute
(author)
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Hugosson, Jonas,1955University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrenska University Hospital(Swepub:gu)xhugjo
(author)
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Marlow, T.Nordic Health Economics AB
(author)
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Stinesen-Kollberg, KarinUniversity of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institutionen för socialt arbete,Institute of Clinical Sciences, Department of Oncology,Department of Social Work,Sahlgrenska University Hospital(Swepub:gu)xstink
(author)
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Stranne, Johan,1970University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrenska University Hospital(Swepub:gu)xstraj
(author)
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Wallerstedt, A.Karolinska Institutet,Karolinska Institute
(author)
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Wiklund, PeterKarolinska Institutet,Karolinska Institute(Swepub:lu)extLU-1072
(author)
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Wilderäng, UlricaUniversity of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology(Swepub:gu)xoloul
(author)
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Haglind, Eva,1947University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xhagev
(author)
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Nordic Health Economics ABInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi
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In:European Urology: Elsevier BV74:6, s. 816-8240302-28381873-7560
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