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Minimally Invasive Treatment for Benign Prostatic Hyperplasia: Economic Evaluation from a Standardized Hospital Case Costing System

  • Clinical Investigation
  • Arterial Interventions
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A Correction to this article was published on 02 January 2019

This article has been updated

Abstract

Purpose

Minimally invasive alternatives to transurethral resection of the prostate (TURP) such as prostate arterial embolization (PAE) and photoselective vaporization of the prostate (PVP) are being explored as adjuncts in the care of patients with benign prostatic hyperplasia. However, there are conflicting reports of the costs of these procedures. The purpose of this study was to compare the direct and indirect hospital costs of TURP, PAE and PVP.

Materials and Methods

A chart review was performed in patients who underwent TURP, PVP and PAE from April 2015 to March 2017. All hospital costs were collected in accordance with the Ontario Case Costing Initiative, a standardized medical case costing system. Costs were characterized as direct or indirect and fixed or variable. Probabilistic sensitivity analysis was conducted to study cost uncertainty.

Results

During the study period, a total of 209 men underwent TURP, 28 PVP and 21 PAE. Mean age (years) was as follows: TURP 71.43; PVP 73.66; PAE 70.77 (p = 0.366). Mean length of stay (days) was as follows: TURP 1.63; PVP 1.55; PAE 1 (p = 0.076). Total costs of the PAE group ($3829, SD $1582) were less than both PVP ($5719, SD $1515) and TURP groups ($5034, SD $1997, p < 0.001). There was no significant difference in direct costs between the groups. Monte Carlo simulation demonstrated that PAE was the least costly alternative majority of the time.

Conclusions

The total hospital costs of PAE at our institution are significantly lower than those of PVP and TURP.

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Fig. 1

Adapted from “Hospital Production Function Model,” Ontario Case Costing Guide, Ministry of Health and Long-Term Care

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Change history

  • 02 January 2019

    The original version of this article published previously contained an error.

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Authors and Affiliations

  1. Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, M5G 2N2, Canada

    Andrew D. Brown & Martin E. Simons

  2. Division of Vascular and Interventional Radiology, Department of Radiology, Hamilton Health Sciences, McMaster University Medical Centre, McMaster University, Hamilton, ON, Canada

    Steffan F. Stella

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  1. Andrew D. Brown
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Correspondence to Andrew D. Brown.

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This study has obtained IRB approval from research ethics board (University Health Network), and the need for informed consent was waived.

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Brown, A.D., Stella, S.F. & Simons, M.E. Minimally Invasive Treatment for Benign Prostatic Hyperplasia: Economic Evaluation from a Standardized Hospital Case Costing System. Cardiovasc Intervent Radiol 42, 520–527 (2019). https://doi.org/10.1007/s00270-018-2132-8

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  • DOI: https://doi.org/10.1007/s00270-018-2132-8

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