721 860
Abdollah (2011)
[26]
1188 MIRP
3354 RRP
Population-based
retrospective
cohort
Florida Hospital
Inpatient data 2008
MIRP
versus RRP
Total undiscounted
charges
Only charges
measured
Payer
Median MIRP charge: $33 234 (2008)
Median RRP charge: $33 674 (2008)
Difference MIRP versus RRP: –$440 (2008)
Charges lower for MIRP than RRP if a high case
volume, higher if a low case volume.
Risk of bias high, because charges were not
adjusted for patient factors (eg, age,
comorbidity, SES).
Epstein (2013)
[32]
10 032 MIRP
13 778 RRP
Retrospective
cohort study
Truven MarketScan
database 2000–2009
(employer-sponsored
health plans)
MIRP
versus RRP
1. Health plan
expenditures on
medical care,
including both
medical and pharmacy
costs
2. Days absent from
work
Expenditures were
measured
(presumably
representing both
direct and indirect
costs)
Payer
Societal
MIRP spending significantly higher than that
for RRP in adjusted analyses ($1350 in the 1st
year after surgery, 2009).
Days absent from work significantly shorter
after MIRP than RRP in adjusted analyses (9 d).
Risk of bias is moderate, as unobserved
confounding may have affected results.
Cooperberg (2013)
[35]NA
Cost utility
analyses
Review of the
published literature to
estimate outcomes
RARP
versus RRP
Decision-analytic
Markov model to
evaluate QALYs, and
lifetime costs. Costs
for visits and
procedures derived
from the
2009 National
Medicare Fee schedule
Direct costs and
sensitivity analyses
incorporating cost to
patient (time off work)
Payer
Direct medical RARP cost:$8547 (2009)
Direct medical RRP cost: $8056 (2009)
Difference RARP versus RRP: $491 (2009)
No significant difference in QALYs comparing
RARP and RRP.
No significant difference in mean discounted
lifetime costs comparing RARP and RRP.
Risk of bias low, as sensitivity analyses
changing many assumptions did not change
the outcome of the analyses.
Anderson (2012)
[79]12 588 RARP
8968 RRP
Population-based
retrospective
cohort
Nationwide Inpatient
Sample 2008–2009
RARP
versus RRP
Total charges
Only charges
measured
Payer
Mean RARP charge: $38 542 (2009)
Mean RRP charge: $33 934 (2009)
Difference RARP versus RRP: $4608 (2009)
After adjustment, RARP charges remained
statistically significantly higher than RRP
charges (exact number not given).
RARP had shorter LOS (1 d).
Risk of bias moderate, because charges are
unlikely to reflect true cost.
Gandaglia (2014)
[80]
3476 RARP
2439 open RP
Retrospective
cohort study
SEER-Medicare 2008–
2009
RARP vs
open RP
Medicare
expenditures in the
year after surgery
minus those in the
year prior to surgery
Medicare
expenditures
measured
Payer
RARP median expenditure: $13 395 (2009)
Open RP median expenditure: $11 970 (2009)
Difference: $1425 (2009)
Risk of bias is high, because 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 the expense of caring for
underinsured patients
[16]
.Kim (2015)
[33]
8981 MIRP
8629 RRP
Retrospective
cohort study
IMS LifeLink Health
Plan Claims Database
2003–2010
MIRP
versus RRP
Hospital
reimbursement
(amount allowed by
insurance)
Expenditures were
measured
(presumably
representing both
direct and indirect
costs)
Payer
Median MIRP reimbursement: $16 661 (2010)
Median RRP reimbursement: $14 784 (2010)
Adjusted mean hospital reimbursement was
$1945 (2010) more per case for MIRP versus
RRP (adjusted for age, comorbidity, region, and
year).
Risk of bias moderate as residual confounding
may be present.
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
721