High-Tech Prostate Cancer Treatments: A Cost Analysis
Dr. David Samadi, robotic prostatectomy surgeon, reports findings from a financial review of prostate cancer treatments at The Mount Sinai Medical Center
Staying ahead of the curve often comes with a price. In the case of prostate cancer, treatment innovations fuel ongoing debate over the cost-benefit analysis of new technologies and modalities. In an institution-based study led by Dr. David Samadi , Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York, Robotic-Assisted Laparoscopic Prostatectomy (RALP) was found to be less than half the cost of radiation.
Focused on localized prostate cancer treatments from 2005 to 2009, researchers compared Mount Sinai hospital expenses for open prostate surgery, robotic surgery, brachytherapy seed radiation, Intensity Modulated Radioactive Therapy (IMRT), and a combination of brachytherapy and IMRT. Among the findings presented by Dr. Samadi at the European Association of Urology 27th Annual Congress in Paris last February, was a savings of more than $8,000 per RALP procedure over IMRT radiation.
Median cost comparison for prostate cancer treatment options:
- Brachytherapy: $7,560
- Robotic prostate removal surgery: $7,676
- Open prostate removal surgery: $8,991
- Radiation therapy (IMRT): $15,929
- Brachytherapy/IMRT combined for high-risk patients: $22,447
"In the past, robotic prostatectomy was regarded as a more expensive prostate cancer treatment. Now we see that may not be the case," said Dr. Samadi. "When we layer these findings with prior research, we fortify the case in favor of robotic prostatectomy," said Dr. Samadi. In September 2012 a comparative results study of radical prostatectomy verses External Beam Radiation Therapy (EBRT) demonstrated an increased survival rate of 40 and 65 percent with RALP. Of the 1,600 localized prostate cancer patients reviewed in the study, two-thirds underwent prostatectomy. http://www.renalandurologynews.com/pca-patient-survival-better-with-rp/article/241954/
Dr. Samadi performs a unique RALP surgery at Mount Sinai coined the Samadi Modified Advanced Robotic Technique (SMART). Having performed more than 4,500 successful robotic prostatectomy procedures, he and his colleagues credit part of the financial savings of surgery to the expertise that comes from their high volume of prostatectomies. Dr. Samadi's SMART procedure reduces surgical time to under two hours, considerably less than those performed at other institutions. Likewise, for most patients, hospital stay is as short as one day.
These figures represent expense to the hospital and not the patient. As such, Dr. Samadi is hopeful that the findings will be instrumental in improving reimbursement decisions regarding prostate cancer surgery, particularly when aligned with successful recovery results. "While the best prostate cancer treatment will always depend on the patient's unique condition, we continue to see documented support for the cost and recovery benefits of RALP," concluded Dr. Samadi.
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