Cost analysis of Greenlight photoselective vaporization of the prostate compared to transurethral resection of the prostate for benign prostatic hyperplasia

  • Lisa Masucci 1. Toronto Health Economics and Technology Assessment Collaborative (THETA), University of Toronto, Toronto, ON, Canada 2. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
  • Aysegul Erman 1. Toronto Health Economics and Technology Assessment Collaborative (THETA), University of Toronto, Toronto, ON, Canada 3. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
  • Murray D. Krahn 1. Toronto Health Economics and Technology Assessment Collaborative (THETA), University of Toronto, Toronto, ON, Canada 2. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada 3. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada 4. Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada
  • Dean Elterman 5. Division of Urology, University of Toronto, Toronto, ON, Canada 6. Toronto Western Hospital, University Health Network, Toronto, ON, Canada

Abstract

Introduction: Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which results in the development of lower urinary tract symptoms that can interfere with patients’ daily activities and negatively impact their quality of life. The gold standard treatment for moderate to severe BPH has been transurethral resection of the prostate (TURP), however, this procedure is associated with prolonged hospitalizations and increased complications. An alternative to TURP is Greenlight photoselective vaporization of the prostate (PVP), which is associated with better perioperative safety. The objectives of the research were to: 1) assess the cost of Greenlight PVP compared to TURP and bipolar TURP; and 2) assess the predictors of total cost.

Methods: We conducted a descriptive costing study from the hospital perspective. We evaluated perioperative costs of patients who underwent each procedure from 2013–2015 at a tertiary academic medical centre. A multiple linear regression was performed to identify predictors of total cost. The variables included in regression analysis were patient age, type of procedure, Charlson Comorbidity Index, and distance to clinic.

Results: A total of 202 patients received one of the three procedures over the study period. The total cost of Greenlight PVP was $3836 per patient compared to $4963 for TURP and $4978 for bipolar TURP. The linear regression showed that the Charlson Comorbidity Index and type of procedure were independent predictors of total cost.

Conclusions: The procedure costs and readmission rates are lower for Greenlight PVP compared to TURP and bipolar TURP, making it a preferable option for hospitals.

Published
2018-06-19
How to Cite
Masucci, L., Erman, A., Krahn, M. D., & Elterman, D. (2018). Cost analysis of Greenlight photoselective vaporization of the prostate compared to transurethral resection of the prostate for benign prostatic hyperplasia. Canadian Urological Association Journal, 12(12). https://doi.org/10.5489/cuaj.5267
Section
Original Research