716 860
Table 1 – Studies comparing costs of RARP and RRP
Study
Patients, no.
Type of
study
Data source
Comparison Cost definition
Costs included
(direct vs indirect)
Perspective
Main findings
including comment
on risk of bias
Studies from the hospital’s perspective
Lotan (2004)
[8]
NA
Cost modeling Intrainstitutional costs
were obtained from
billing department,
supplemented by data
from literature
RARP
versus RRP
Costs modeled in
decision tree analyses
Direct and indirect
costs, including
purchase cost and
amortization of robot
Hospital
Mean RARP cost: $7280
Mean RRP cost: $5554
Difference: $1726
(no adjustment for inflation done)
Data are based on one individual hospital and
may not be generalizable to other settings.
Risk of bias moderate due to uncertainty of the
data abstracted from the literature.
Scales (2005)
[25]
NA
Cost modeling Intrainstitutional costs
were obtained from
billing department,
supplemented by data
from literature
RARP
versus RRP
Costs modeled in
decision analytic
model
Direct and indirect
costs including
purchase cost and
amortization of robot
Hospital
RARP cost: $8929 (2004)
RRP cost: $8734 (2004)
Difference:$195 (2004)
Above number for calculation in specialist
setting.
Additional findings: RARP cost mainly
depended on LOS and cost of room and board.
Data are based on one individual hospital and
may not be generalizable to other settings.
Risk of bias moderate due to uncertainty of the
data abstracted from the literature.
Mouraviev (2007)
[21]
137 RARP
197 RRP
Retrospective
cohort study
Institutional database
2002–2005
RARP
versus RRP
Total direct hospital
costs and grand total
hospital costs
including direct,
indirect expenses
Obtained direct and
indirect costs from
local hospital
accounting (cost of
robot and
maintenance not
included)
Hospital
Mean RARP cost: $10 047
Mean RRP cost: $10 704
Difference: –$657
(no adjustment for inflation done, statistically
significant difference)
Risk of bias is high. No adjusted models were
constructed. RRP patients were slightly older.
Comorbidities were not reported.
Lotan (2010)
[63]246 RARP
157 RRP
Retrospective
cohort study
Private hospital billing
and accounting data
2000–2008
RARP
versus RRP
Costs estimated based
on local hospital
accounting system
Total, direct, and
indirect costs (cost of
robot and
maintenance not
included)
Hospital
Mean RARP cost: $10 269
Mean RRP cost: $6473
Difference: $3796
(no adjustment for inflation done)
RARP not profitable for hospital.
Data are based on one individual hospital and
may not be generalizable to other settings.
Hospital cost accounting likely differs from
hospital to hospital.
Risk of bias is high because patient differences
are not reported and accounted for.
Bolenz (2010)
[64]
262 RARP
156 RRP
Retrospective
cohort study
Institutional database
2003–2008
RARP
versus RRP
Direct costs obtained
from the hospital
billing department
Direct costs (cost of
robot and
maintenance not
included)
Hospital
Mean RARP direct cost: $6749 (2007)
Mean RRP direct cost: $4514 (2007)
Difference RARP versus RRP:$2235 (2007)
Risk of bias high because the above costs were
not adjusted for patient factors. Study was
focused on impact of BMI, not on cost
comparison between the two modalities.
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 7 1 2 – 7 3 5
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