A single-institution cost analysis of 115 robotic-assisted laparoscopic radical prostatectomies (RARPs) and 358 open radical retropubic prostatectomies (RRPs) revealed that the overall cost per case for RARP exceeded the cost for RRP by about $5,300.
The cost analysis was based on all men with prostate cancer undergoing RARP or RRP from July 2009 to October 2010 by one of four surgeons at the University of Pittsburgh (Pennsylvania) Medical Center (UPMC) Shadyside Hospital. The mean total costs per case for RARP exceeded the total costs for RRP by 62%: $14,006 ± $1,641 vs $8,686 ± $1,989). Because payment to the hospital from all sources was nearly equivalent at $10,011 for RRP and $9,993 for RARP, the average profit for each RRP was $1,325, compared with a loss of $4,013 for each RARP.
The main contributors to the increased RARP expenses were higher operating room supply costs (nearly seven times greater for RARP, at $2,852 ± $528 compared with $417 ± $59 for RRP) and indirect costs associated with the purchase and maintenance of the robotic equipment. The two approaches did not differ significantly in terms of ancillary, cardiology, imaging, administrative, laboratory, and pharmacy costs.
The investigative team, led by Joel B. Nelson, MD, chairman of the Department of Urology at UPMC, reported in Urology no significant difference in mean length of stay in RARP patients (1.2 days) compared with RRP patients (1.4 days).