719 860
Bijlani (2016)
[29]
NA
Cost modeling Review of the
published literature to
estimate outcomes
RARP
versus RRP
Costs modeled based
on care pathways and
published government
and other sources
Reimbursements for
procedure,
complications,
functional outcomes,
and adjuvant
treatment within 3 yr
Direct and indirect
costs, including
purchase and
maintenance cost of
robot
Hospital
Payer
Societal
RARP cost $341 (2014) more than RRP.
RARP saved $1451 (2014), mainly because of
lower complication, incontinence, and sexual
dysfunction costs.
RARP saved $1202 due to faster recovery and
less lost wages.
Risk of bias and potential for COI is high as this
study was conducted by Intuitive Surgical
employees.
Note: In the payer perspective analyses, no
sensitivity analyses are presented, which
would have been helpful as estimates around
incontinence and sexual dysfunction vary a lot
in the literature.
Studies from the payer’s perspective
Burgess (2006)
[75]
78 RARP
16 RRP
Retrospective
cohort study
Institutional database
2002–2004
RARP
versus RRP
Hospital charges
obtained from patient
bills
Only charges
measured
Payer
Mean RARP charges: $39 315 (2003)
Mean RRP charges: $31 518 (2003)
Difference RARP versus RRP: $7797 (2003)
Risk of bias high because the above costs were
not adjusted for patient factors and because
the number of included patients was low.
Nguyen (2011)
[39]
N
not given for
MIRP and RRP
Retrospective
cohort study
SEER-Medicare 2002–
2005
MIRP
versus RRP
Medicare payments in
the year after
diagnosis minus those
in the year prior to
diagnosis
Medicare payments
Payer
Mean MIRP cost: $16 762 (2008)
Mean RRP cost: $16 469 (2008)
Difference: $293 (2008)
Risk of bias high. No adjusted models were
constructed. MIRP patients were of better
socioeconomic status and had lower-risk
disease.
Additionally, Medicare reimbursement varies
by many intentional factors other than type of
treatment, including, for example, price
differences based on regional wage disparities,
cost of living, illness severity, and expense of
caring for underinsured patients
[16]
.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
719