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

Whitty, Jennifer A., Crosland, Paul, Hewson, Kaye, Narula, Rajan, Nathan, Timothy R., Campbell, Peter A., Keller, Andrew and Scuffham, Paul A. (2014) 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. BJU International, 113 SUPPL. 2: 21-28. doi:10.1111/bju.12051


Author Whitty, Jennifer A.
Crosland, Paul
Hewson, Kaye
Narula, Rajan
Nathan, Timothy R.
Campbell, Peter A.
Keller, Andrew
Scuffham, Paul A.
Title 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
Journal name BJU International   Check publisher's open access policy
ISSN 1464-4096
1464-410X
Publication date 2014-03-01
Year available 2013
Sub-type Article (original research)
DOI 10.1111/bju.12051
Volume 113
Issue SUPPL. 2
Start page 21
End page 28
Total pages 8
Place of publication West Sussex United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2748 Urology
Formatted abstract
Objectives: 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.
Patients and Methods: A decision-analytic model was used to compare the costs of PVP and TURP. Cost inputs were sourced from an audit of patients undergoing PVP or TURP across three hospitals. The probability of re-intervention was obtained from secondary literature sources. Probabilistic and multi-way sensitivity analyses were used to account for uncertainty and test the impact of varying key assumptions.
Results: In the base case analysis, which included equipment, training and re-intervention costs, PVP was AU$ 739 (95% credible interval [CrI] -12187 to 14516) more costly per patient than TURP. The estimate was most sensitive to changes in procedural costs, fibre costs and the probability of re-intervention. 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 -13026 to 13678, respectively). However, CrIs were wide for all analyses.
Conclusions: In this cost minimisation analysis, there was no significant cost difference between PVP and TURP, after accounting for equipment, training and re-intervention costs. 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.
Keyword Australia
Benign prostatic hyperplasia
Cost-minimisation analysis
Photoselective vaporisation of the prostate
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
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