Cost comparison among robotic, laparoscopic, and open hysterectomy for endometrial cancer.

Published

Journal Article

OBJECTIVE: To use decision modeling to compare the costs associated with robotic, laparoscopic, and open hysterectomy for the treatment of endometrial cancer. METHODS: Three separate models were used, each with sensitivity analysis: 1) a societal perspective model, which included inpatient hospital costs, robotic expenses, and lost wages and caregiver costs; 2) a hospital perspective plus robot costs model, which was identical to the societal perspective model but excluded lost wages and caregiver costs; and 3) a hospital perspective without robot costs model, which was identical to the hospital perspective plus robot costs model except that it excluded initial cost of the robot. RESULTS: The societal perspective model predicted laparoscopy ($10,128) as the least expensive approach followed by robotic and ($11,476) and open hysterectomy ($12,847). Societal perspective model sensitivity analyses predicted robotic hysterectomy to be least expensive when robotic disposable equipment cost less than $1,046 per case (baseline cost $2,394). In the hospital perspective plus robot costs model, laparoscopy was least expensive ($6,581) followed by open ($7,009) and robotic hysterectomy ($8,770); however, if hospital stay after open surgery was less than 2.9 days, open hysterectomy was least expensive. In the hospital perspective without robot costs model, laparoscopy remained least expensive, but robotic surgery became least expensive if the cost of robotic disposable equipment was reduced to less than $1,496 per case. CONCLUSION: Laparoscopy is the least expensive surgical approach for the treatment of endometrial cancer. Robotic is less costly than abdominal hysterectomy when the societal costs associated with recovery time are accounted for and is most economically attractive if disposable equipment costs can be minimized. LEVEL OF EVIDENCE: III.

Full Text

Duke Authors

Cited Authors

  • Barnett, JC; Judd, JP; Wu, JM; Scales, CD; Myers, ER; Havrilesky, LJ

Published Date

  • September 2010

Published In

Volume / Issue

  • 116 / 3

Start / End Page

  • 685 - 693

PubMed ID

  • 20733453

Pubmed Central ID

  • 20733453

Electronic International Standard Serial Number (EISSN)

  • 1873-233X

Digital Object Identifier (DOI)

  • 10.1097/AOG.0b013e3181ee6e4d

Language

  • eng

Conference Location

  • United States