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KMID : 1170320220280040029
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Korean Journal of Health Economics and Policy
2022 Volume.28 No. 4 p.29 ~ p.54
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The cost-effectiveness analysis of robot assisted radical prostatectomy for localized prostate cancer in Korea
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Hwang Ji-Woo
Woo Jae-Hyun
Kim Sung-Min
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Abstract
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A radical prostatectomy is used as a treatment for localized prostate cancer. There are three methods of prostatectomy: Open radical prostatectomy(ORP), laparoscopic-assisted radical prostatectomy(LRP), and robotic assisted radical prostatectomy(RARP). ORP and LRP are covered by health insurance, and RARP is undergoing without health insurance. As a result of cost-effectiveness analysis of the three methods in 2014, it was concluded that RARP was not cost-effective and no follow up research has been conducted. This study used accumulated health care data to analyze the cost-effectiveness of the three methods of radical prostatectomy from health care system perspective, and additionally performed scenario analysis. For the analysis, Markov model was constructed with five health state and simulated 65 year old male after radical prostatectomy for localized cancer. Input data used for the model were extracted from the literature, national statistical portal, and Health Insurance Review and Assessment Service data. The final result was shown as an incremental cost-effectiveness ratio(ICER), and the ICER was judged compared to the GDP per capita. Basic data analysis showed that the ICER compared with RARP, ORP was 33,648,123WON/QALY, lower than ICER threshold and compared with ORP, LRP, the effect of ORP was higher than LRP, so ORP was dominant. The most sensitive variable influencing the ICER was the hazard ratio, risk ratio for biochemical recurrence and the length of hospital stay also had a significant impact. However, due to the limitations of the input data, the uncertainty of the cost-effectiveness results is large, so it is necessary to adjust the input values later and approach them again.
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KEYWORD
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Cost-effectiveness analysis, RARP, LRP, ORP, ICER
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