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

作者：Whitty Jennifer A^*; Crosland Paul; Hewson Kaye; Narula Rajan; Nathan Timothy R; Campbell Peter A; Keller Andrew; Scuffham Paul A

来源：BJU International, 2014, 113: 21-28.

DOI：10.1111/bju.12051

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

Objectives %26lt;br%26gt;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. %26lt;br%26gt;Patients and Methods %26lt;br%26gt;A decision-analytic model was used to compare the costs of PVP and TURP. %26lt;br%26gt;Cost inputs were sourced from an audit of patients undergoing PVP or TURP across three hospitals. %26lt;br%26gt;The probability of re-intervention was obtained from secondary literature sources. %26lt;br%26gt;Probabilistic and multi-way sensitivity analyses were used to account for uncertainty and test the impact of varying key assumptions. %26lt;br%26gt;Results %26lt;br%26gt;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. %26lt;br%26gt;The estimate was most sensitive to changes in procedural costs, fibre costs and the probability of re-intervention. %26lt;br%26gt;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. %26lt;br%26gt;Conclusions %26lt;br%26gt;In this cost minimisation analysis, there was no significant cost difference between PVP and TURP, after accounting for equipment, training and re-intervention costs. %26lt;br%26gt;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.

• 出版日期2014-3