722 860
Table 1 (
Continued
)
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
Eldefrawy (2013)
[36]
NA
Cost modeling Primarily based on
institutional data 2010
RARP
versus RRP
Markov model to
evaluate the cost of
complications and
recurrence
Inpatient costs derived
from internal
institutional data
Costs for visits and
procedures derived
from the 2010 Florida
Medicare
reimbursement
Costs were based on
Medicare
reimbursement rates
Payer
10-yr cost RARP: $22 762 (2010)
10-yr cost RRP: $15 084 (2010)
Difference RARP versus RRP: $7678 (2010)
Risk of bias is moderate because no sensitivity
analyses were performed to test the impact of
the many assumptions on the outcome of the
cost model.
Hyams (2013)
[81]1499 RARP
2565 RRP
Retrospective
cohort study
State of Maryland
Health Service Cost
Review Commission
discharge database
2008–2011
RARP
versus RRP
Likely charges were
examined, although
this is not explicitly
stated
Likely charges
examined
Payer
Mean RARP charges: $14 000 (2011)
Mean RRP charges: $10 100 (2011)
Difference: $3900 (2011)
Significant difference persists after adjusting
for age, race, patient complexity, LOS, ICU stay,
insurance status.
Risk of bias is moderate because residual
confounding is likely present.
Charges are unlikely to be meaningful because
hospitals can freely set charge master rates.
While most markups fall into the 1.5–4 range
relative to Medicare allowable cost, the
markup may be more than 10 times that cost
[19]
.Niklas (2016)
[27]122 RARP
700 RRP
Retrospective
cohort study
German Statutory
Health Insurance
database 2009–2012
RARP
versus RRP
German Statutory
Health Insurance
payments over 4 yr
(2009–2012)
German Statutory
Health Insurance
payments
Payer
Mean RARP cost:
s
21 674
Mean RRP cost:
s
24 512
Difference: –
s
2865
Risk of bias high: 4 yr of cost after diagnosis
and treatment was examined. There could have
been many reasons for why costs were lower
among men undergoing RARP, including higher
socioeconomic status and overall better health
in this group of men, none of which were
accounted for in the analyses.
Hughes (2016)
[28]5858 RARP
7806 open RP
Retrospective
cohort study
National UK Hospital
Episode Statistics data
2008– 2013
RARP versus
open RP
Costs based on
National Health
Service tariffs for 2013
Includes direct and
indirect costs, only
after discharge from
hospital
Payer
RARP mean f/u cost at 1 yr: £1679 (2013)
Open RP mean f/u cost at 1 yr: £2031 (2013)
Difference: –£352 (2013)
Risk of bias is high. No adjusted models were
constructed. Healthier patients may have
chosen RARP explaining the cost savings.
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
722