Table 34:
Hospitalization Cost of Robot-Assisted and Open Radical Prostatectomy, Including Readmission
| Health Care Resource | Unit Price, $a | RARPa | ORPa | ||
|---|---|---|---|---|---|
| Resource Use, Mean (95% CI) | Cost, $ | Resource Use, Mean (95% CI) | Cost, $ | ||
| Robotic equipment and service contract | — | — | 5,265 | — | NAb |
| Consumables and disposables | — | — | 3,476c | — | 273 |
| Operating room | 1,278/hour125 | 4.10 (3.96, 4.24)26 | 5,241 | 4.67 (4,57, 4.77)26 | 5,971 |
| Recovery room | 221/hour130 | 1.80 (1.64, 1.96)26 | 397 | 1.79 (1.40, 2.18)26 | 394 |
| Surgical bed | 1,037/day125 | 1.55 (1.41, 1.96)26 | 1,607 | 3.27 (3.03, 3.51)26 | 3,390 |
| Surgeon fees | — | — | 1,508127,c,d | — | 1,081127c,d |
| Anaesthesia | 15/unit127 | 10.00127 | 150 | 10.00127 | 150 |
| Blood transfusion | 757/transfused patient125 | 0.01 (0, 0.03)26 | 8 | 0.04 (0.01, 0.08)26 | 30 |
| Readmissione | 4,334125,127,130 | 0.05 (0.02, 0.1)26 | 217 | 0.08 (0.04, 0.13)26 | 347 |
| Total average costs | — | — | 17,869 | — | 11,636 |
Abbreviations: CI, confidence interval; ORP, open radical prostatectomy; RARP, robot-assisted radical prostatectomy.
In the probabilistic sensitivity analysis, we used the fixed values for the unit price and gamma distributions for the resource uses for both groups. All costs are in 2016 Canadian dollars.
Although there are equipment-related costs for ORP, the surgical equipment is often not solely dedicated for ORP. In the long-term, the attributable cost of equipment for ORP is likely to be small, assuming that the service life of the equipment is long and the volume of (different types of) surgeries is large. Since this cost is relatively small and difficult to quantify, we have excluded it from this analysis.
We used the ± 25% of the point estimate in the deterministic sensitivity analysis, and assumed the standard error is 20% of the point estimate in the probabilistic sensitivity analysis.
The Ontario Schedule of Benefits127 includes the cost for the surgical assistant service (8 units for RARP and 6 units for ORP).
We assumed that one readmission would consume 1 hour of operating room time, 2 hours of recovery room time, 2 days of hospitalization, and a professional fee of 50% of the ORP cost ($4,334 total).