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Background <p>The economic impact of RARP versus laparoscopic (LRP) or open surgical radical prostatectomy (OSRP) is unclear. The objective is to estimate and compare the total cost of radical prostatectomy with and without robot assistance from the French establishment perspective. This estimate can assess the cost benefit of robotic-assisted radical prostatectomy (RARP) and determine who should pay.</p> Methods <p>A micro-costing bottom-up time-and-motion approach was used based on 2018 prices (€). In public hospitals, observed data for OSRP and RARP was used; in private hospitals, expert opinions were sought from clinicians for RARP and LRP. Average costs, costs per minute of surgery and costs per expenditure were compared between techniques. A sensitivity analysis accounted for variability in cost of personnel and amortized cost of Da Vinci robot.</p> Results <p>The average estimated cost of surgery was 4683.35€ [95% CI=2900; 6467.2] more for RARP versus LRP in private clinics, and 3744€ [95% CI=3525; 3963] for RARP versus OSRP in public hospital. Recovery costs were equivalent between techniques (112.9€ for RARP and LRP in private and 46.1€ [95% CI=31.8; 60.4] for OSRP and 47.8€ [95% CI=39.1; 56.5] for RARP in public hospital). The sensitivity analysis confirmed the extra cost for RARP versus LRP or OSRP.</p> Conclusions <p>Depending on the surgery compared (OSRP or LRP), institute type (public or private) and data source (observed or expert opinion), the extra cost of the robot varied from 3744€ to 4683.35€. The amortized cost of the robot and its specific materials were the main elements of the difference.</p> Trial registration <p>This comparative, multi-centre economic study combines one secondary objective from the RoboProstate study (NCT01577836) and part 1 of the OptiPRobot study (IRB #19.07.03).</p>

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Robot-assisted approach versus open surgery and conventional laparoscopy for radical prostatectomy for prostate cancer: a micro-costing study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月5日

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  • Sophie Bouvet,
  • Sihame Chkair,
  • Jean Pierre Daurès,
  • Sarah Kabani,
  • Anne Damman,
  • Gregoire Poinas,
  • Sandy Lacombe,
  • Marie Paule Bourbon,
  • Renaud Lardon,
  • Anne Claire Masson,
  • Sylvie Tilhet Chassaigne,
  • Jean Baptiste Roche,
  • Laurence Ponroy,
  • Xavier Cathelineau,
  • Thomas Pignier,
  • Thierry Chevallier,
  • Eric Lechevallier,
  • Stéphane Droupy

摘要

Background

The economic impact of RARP versus laparoscopic (LRP) or open surgical radical prostatectomy (OSRP) is unclear. The objective is to estimate and compare the total cost of radical prostatectomy with and without robot assistance from the French establishment perspective. This estimate can assess the cost benefit of robotic-assisted radical prostatectomy (RARP) and determine who should pay.

Methods

A micro-costing bottom-up time-and-motion approach was used based on 2018 prices (€). In public hospitals, observed data for OSRP and RARP was used; in private hospitals, expert opinions were sought from clinicians for RARP and LRP. Average costs, costs per minute of surgery and costs per expenditure were compared between techniques. A sensitivity analysis accounted for variability in cost of personnel and amortized cost of Da Vinci robot.

Results

The average estimated cost of surgery was 4683.35€ [95% CI=2900; 6467.2] more for RARP versus LRP in private clinics, and 3744€ [95% CI=3525; 3963] for RARP versus OSRP in public hospital. Recovery costs were equivalent between techniques (112.9€ for RARP and LRP in private and 46.1€ [95% CI=31.8; 60.4] for OSRP and 47.8€ [95% CI=39.1; 56.5] for RARP in public hospital). The sensitivity analysis confirmed the extra cost for RARP versus LRP or OSRP.

Conclusions

Depending on the surgery compared (OSRP or LRP), institute type (public or private) and data source (observed or expert opinion), the extra cost of the robot varied from 3744€ to 4683.35€. The amortized cost of the robot and its specific materials were the main elements of the difference.

Trial registration

This comparative, multi-centre economic study combines one secondary objective from the RoboProstate study (NCT01577836) and part 1 of the OptiPRobot study (IRB #19.07.03).