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Cost analysis of open radical cystectomy versus robot‐assisted radical cystectomy
Author(s) -
Bansal Sukhchain S.,
Dogra Tara,
Smith Peter W.,
Amran Maisarah,
Auluck Ishna,
Bhambra Maninder,
Sura Manraj S.,
Rowe Edward,
Koupparis Anthony
Publication year - 2018
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14044
Subject(s) - cystectomy , cost analysis , operations management , offset (computer science) , urinary diversion , computer science , medicine , operations research , engineering , operating system , cancer , bladder cancer
Objectives To perform a cost analysis comparing the cost of robot‐assisted radical cystectomy ( RARC ) with open RC ( ORC ) in a UK tertiary referral centre and to identify the key cost drivers. Patients and Methods Data on hospital length of stay ( LOS ), operative time ( OT ), transfusion rate, and volume and complication rate were obtained from a prospectively updated institutional database for patients undergoing RARC or ORC . A cost decision tree model was created. Sensitivity analysis was performed to find key drivers of overall cost and to find breakeven points with ORC . Monte Carlo analysis was performed to quantify the variability in the dataset. Results One RARC procedure costs £12 449.87, or £12 106.12 if the robot was donated via charitable funds. In comparison, one ORC procedure costs £10 474.54. RARC is 18.9% more expensive than ORC . The key cost drivers were OT , LOS , and the number of cases performed per annum. Conclusion High ongoing equipment costs remain a large barrier to the cost of RARC falling. However, minimal improvements in patient quality of life would be required to offset this difference.