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A multicentre cost-effectiveness and Patient Reported Outcome Measures (PROM) comparison study between laparoscopic and robotic assisted radical prostatectomy
BAUS ePoster online library. Good D. 11/10/20; 304211; P10-3
Disclosure(s): Prostate Scotland / The Urology Foundation Robotic Urology
A multicentre cost-effectiveness and Patient Reported Outcome Measures (PROM) comparison study between laparoscopic and robotic assisted radical prostatectomy
Good D1, Stoddart A4, Challacome B3, Cahill D2, McNeill A1 1Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, United Kingdom, 2Royal Marsden Hospital, London, UK, 3Guys and St Thomas' NHS Trust, London, UK, 4Edinburgh Clinical Trials Unit, University of Edinburgh, UK
Objective: To assess if there were any statistically and clinically significant differences in cost effectiveness and PROM data between LRP and RARP between 3 high volume UK units.
Patients and Methods: Baseline, 6 weeks, 3 and 12 month EPIC-26 (UI, UO, Bowel, Sexual, Hormonal), Decision regret score (DRS) and EQ5D5L questionnaires were used. Capital, maintenance costs as well as in hospital and post hospital health care resource utilisation within 1 year of surgery were used for health economic analyses.
Results: 439 patients (201 in LRP and 238 in RARP groups) were included. The groups were similar in age, BMI and PSA. There was a statistically significantly lower early (=3mo post op) overall DRS for the RARP compared to LRP group and when adjusted for cT2, Bilateral Nerve Sparing (BNS) status. For EPIC-26 UI there were significantly better scores for RARP vs LRP groups for overall comparison and when adjusted for cT2 status, cT3 and all nerve sparing variations. For EPIC-26 sexual there were significantly better scores for RARP vs LRP for overall, cT2, BNS and D'Amico low risk status at 12months post-op. Despite the worse PROM outcomes all economic analyses including high case volumes (1000 cases/year), LRP was considered the more cost-effective intervention. This was primarily driven by the capital investment and maintenance costs totalling £400k+ per year.
Conclusion: The main benefits of RARP appear mainly related to nerve sparing. New robotic systems will need to reduce their costs and demonstrate nerve sparing ability to become cost effective.
A multicentre cost-effectiveness and Patient Reported Outcome Measures (PROM) comparison study between laparoscopic and robotic assisted radical prostatectomy
Good D1, Stoddart A4, Challacome B3, Cahill D2, McNeill A1 1Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, United Kingdom, 2Royal Marsden Hospital, London, UK, 3Guys and St Thomas' NHS Trust, London, UK, 4Edinburgh Clinical Trials Unit, University of Edinburgh, UK
Objective: To assess if there were any statistically and clinically significant differences in cost effectiveness and PROM data between LRP and RARP between 3 high volume UK units.
Patients and Methods: Baseline, 6 weeks, 3 and 12 month EPIC-26 (UI, UO, Bowel, Sexual, Hormonal), Decision regret score (DRS) and EQ5D5L questionnaires were used. Capital, maintenance costs as well as in hospital and post hospital health care resource utilisation within 1 year of surgery were used for health economic analyses.
Results: 439 patients (201 in LRP and 238 in RARP groups) were included. The groups were similar in age, BMI and PSA. There was a statistically significantly lower early (=3mo post op) overall DRS for the RARP compared to LRP group and when adjusted for cT2, Bilateral Nerve Sparing (BNS) status. For EPIC-26 UI there were significantly better scores for RARP vs LRP groups for overall comparison and when adjusted for cT2 status, cT3 and all nerve sparing variations. For EPIC-26 sexual there were significantly better scores for RARP vs LRP for overall, cT2, BNS and D'Amico low risk status at 12months post-op. Despite the worse PROM outcomes all economic analyses including high case volumes (1000 cases/year), LRP was considered the more cost-effective intervention. This was primarily driven by the capital investment and maintenance costs totalling £400k+ per year.
Conclusion: The main benefits of RARP appear mainly related to nerve sparing. New robotic systems will need to reduce their costs and demonstrate nerve sparing ability to become cost effective.
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