An analysis of benign prostatic hyperplasia surgical treatment reimbursement trends across Canada

Examining provincial changes over the recent decade with comparison to cost of living changes

Authors

  • Anindyo Chakraborty Faculty of Medicine and Health Sciences, McGill University
  • Dean S. Elterman Division of Urology, University Health Network, University of Toronto, Toronto, Canada
  • Nicholas Corsi Wayne State University School of Medicine, Detroit, Michigan, USA
  • David Bouhadana Division of Urology, McGill University, Montréal, QC
  • Gregory Bailly Department of Urology, Dalhousie University, Halifax NS, Canada
  • Premal Patel Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
  • Rowen McLellan Department of Urology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
  • Liam Hickey Department of Urology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
  • Daniel Costa Division of Urology, Queen Elizabeth Hospital, Charlottetown, Prince Edwards’ Island, Canada
  • Matthew Andrews Division of Urology, Department of Surgery, Memorial University, St. John's, NL
  • Howard Evans Division of Urology, University of Alberta, Edmonton, AB, Canada
  • Connor M. Forbes Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
  • Hazem Elmansy Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
  • Malek Meskawi CHUM Department of Urology, University of Montréal, Montréal, QC, Canada
  • Naeem Bhojani CHUM Department of Urology, University of Montréal, Montréal, QC, Canada
  • Bilal Chugtai Department of Urology, Weill Cornell Medicine, New York, New York, United States of America
  • Kevin C. Zorn Department of Surgery, Section of Urology, University of Montréal Hospital Center (CHUM), Montréal, Quebec, Canada, Founder, Director, BPH Canada, Montréal, QC, Canada

DOI:

https://doi.org/10.5489/cuaj.8638

Keywords:

BPH, Turp, Holep, Cost, Canada

Abstract

Introduction: A variety of procedures for the endoscopic surgical treatment of symptomatic benign prostatic hyperplasia (BPH) refractory to medical therapy have existed for decades. The present study examines trends in surgeon compensation for these treatments within Canada.

Methods: The physician fee schedule for BPH surgery across 10 Canadian provinces for the years 2010 and 2023 were obtained. A descriptive study examining first, the provincial reimbursement for transurethral resection of prostate (TURP) and laser ablative/enucleation surgery; second, the difference in TURP reimbursement between 2010 and 2023; and third, the annual change in TURP reimbursement juxtaposed with the annual change in the provincial Consumer Price Index (CPI) and annual salary for the working population aged 35–44.

Results: Seven of 10 Canadian provinces reimburse laser BPH surgery equally to TURP. The average provincial TURP reimbursement is $545, ranging from $451 in Ontario to $688 in Saskatchewan. Since 2010, TURP reimbursement has varied by province from a 0% net change in Ontario to an increase of 21% in Nova Scotia. Reimbursement for TURP has increased at a slower pace than the local CPI, and for half of the provinces at a slower pace than the annual salary for people aged 35–44.

Conclusions: The compensation model for endoscopic BPH surgery does not have a unified structure in Canada that is consistent across provinces, nor does it keep up with inflation, possibly impacting future recruitment, increasing geographic disparities, and most importantly, limiting the adoption of new BPH therapies.

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Published

2024-04-02

How to Cite

Chakraborty, A., Elterman, D. S., Corsi, N., Bouhadana, D., Bailly, G., Patel, P., McLellan, R., Hickey, L., Costa, D., Andrews, M., Evans, H., Forbes, C. M., Elmansy, H., Meskawi, M., Bhojani, N., Chugtai, B., & Zorn, K. C. (2024). An analysis of benign prostatic hyperplasia surgical treatment reimbursement trends across Canada: Examining provincial changes over the recent decade with comparison to cost of living changes. Canadian Urological Association Journal, 18(8). https://doi.org/10.5489/cuaj.8638

Issue

Vol. 18 No. 8 (2024): CUAJ August

Section

Original Research

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