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BJU Int. 2014 Mar;113 Suppl 2:21-8. doi: 10.1111/bju.12051. Epub 2013 Apr 10.

A cost-minimisation analysis comparing photoselective vaporisation (PVP) and transurethral resection of the prostate (TURP) for the management of symptomatic benign prostatic hyperplasia (BPH) in Queensland, Australia.

Author information

1
Centre for Applied Health Economics, School of Medicine, and Population and Social Health Research Program, Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia.

Abstract

OBJECTIVES:

To compare the costs of photoselective vaporisation (PVP) and transurethral resection of the prostate (TURP) for management of symptomatic benign prostatic hyperplasia (BPH) from the perspective of a Queensland public hospital provider.

PATIENTS AND METHODS:

A decision-analytic model was used to compare the costs of PVP and TURP. Cost inputs were sourced from an audit of patients undergoing PVP or TURP across three hospitals. The probability of re-intervention was obtained from secondary literature sources. Probabilistic and multi-way sensitivity analyses were used to account for uncertainty and test the impact of varying key assumptions.

RESULTS:

In the base case analysis, which included equipment, training and re-intervention costs, PVP was AU$ 739 (95% credible interval [CrI] -12 187 to 14 516) more costly per patient than TURP. The estimate was most sensitive to changes in procedural costs, fibre costs and the probability of re-intervention. Sensitivity analyses based on data from the most favourable site or excluding equipment and training costs reduced the point estimate to favour PVP (incremental cost AU$ -684, 95% CrI -8319 to 5796 and AU$ -100, 95% CrI -13 026 to 13 678, respectively). However, CrIs were wide for all analyses.

CONCLUSIONS:

In this cost minimisation analysis, there was no significant cost difference between PVP and TURP, after accounting for equipment, training and re-intervention costs. However, PVP was associated with a shorter length of stay and lower procedural costs during audit, indicating PVP potentially provides comparatively good value for money once the technology is established.

KEYWORDS:

Australia; benign prostatic hyperplasia; cost-minimisation analysis; photoselective vaporisation of the prostate; transurethral resection of the prostate

PMID:
23574626
DOI:
10.1111/bju.12051
[Indexed for MEDLINE]
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