2010

Authors

  • Jennifer Whitty Jennifer Whitty
  • Paul Crosland Paul Crosland
  • Kaye Hewson Kaye Hewson
  • Rajan Narula Rajan Narula
  • Timothy R. Nathan Timothy R. Nathan
  • Peter A. Campbell Peter A. Campbell
  • Andrew Keller Andrew Keller
  • Paul Scuffham Paul Scuffham

Objectives To compare the costs of photoselective vaporisation (PVP) and transurethral resection of the prostate (TURP) for magement of symptomatic benign prostatic hyperplasia (BPH) from the perspective of a Queensland public hospital provider. Patients and Methods A decision-alytic 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 alyses were used to account for uncertainty and test the impact of varying key assumptions. Results In the base case alysis, 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 alyses 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 alyses. Conclusions In this cost minimisation alysis, 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.