Abstract: As the adoption of robotic-assisted surgeries increases and trends towards improved overall survival rates for prostate cancer patients continue to rise, it has become necessary  to evaluate their immediate and long-term financial impacts . The purpose of this study is to compare the cost-effectiveness of open radical cystectomy (ORC) versus robotic-assisted radical cystectomy with intracorporeal urinary diversion (i RARC). Data were derived from individual patient data from a randomized clinical trial at nine surgical centers in the United Kingdom.

The study conducted deterministic and probabilistic sensitivity analyses by employing a health services perspective and using a 90-day timeframe . Findings revealed that i RARC offered advantages in reducing short-term morbidity and associated costs. Although the cost-effectiveness ratio of i RARC exceeded many publicly funded health system thresholds, it reduces short-term morbidity and certain related costs. The incremental cost-effectiveness ratio (ICER) of i RARC per quality-adjusted life year (QALY) gained was £100,008 ($144,312). Subgroups defined by age, tumor  stage, and performance status showed a higher potential for cost-effectiveness.

Article Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806721