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    Robotic partial nephrectomy: Benefits outweigh costs

    The benefits of robot-assisted partial nephrectomy outweigh the health care and surgical costs, a new study found.

    RELATED: Robot linked with improved kidney Ca care

    In terms of quality-adjusted life-years gained, the benefits outweighed the costs to patients and payers by a ratio of five to one, reported the study’s authors, from Precision Health Economics in Los Angeles, Harvard Medical School in Boston, and the University of Southern California, Los Angeles.

    The study appears in Health Affairs (2015; 34:220-8).

    The researchers set out to determine if the investment in a surgical robot could be linked to improvements in long-term patient outcomes. They found that partial nephrectomy was associated with significantly lower rates of renal failure when compared with radical nephrectomy. The study also concluded that the costs incurred in adopting robot-assisted surgery were offset by higher survival and lower renal impairment rates.

    "This study demonstrates the benefits—and pitfalls—of comparative research," said Dana P. Goldman, PhD, of Precision Health Economics and the University of Southern California. "While multiple surgical techniques may be equally beneficial, it turns out only robotic surgery can ensure that more patients get the best treatment."

    The study found that adoption of robot-assisted minimally invasive surgery led to a 52% increase in the rate of kidney-sparing partial nephrectomy versus radical nephrectomy, according to a news release from Intuitive Surgical. The 5-year net benefit per procedure (in terms of the difference between quality-adjusted survival gains and health care costs incurred) was $406,217 for radical and $512,561 for partial nephrectomy patients, for an incremental value of $106,344 for each patient who received partial versus radical nephrectomy.

    The study found that if all hospital referral regions (HRRs) had adopted the da Vinci Surgical System, there would have been an additional 23,166 partial nephrectomies performed over the study period. Valuing each partial nephrectomy procedure at $106,344 would have generated an additional $2.5 billion in value had the robot been adopted across all HRRs, the release stated.

    Next: Availability of robot-assisted surgery

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