Review of a decision by the Medical Services Advisory Committee based on health technology assessment of an emerging technology: The case for remotely assisted radical prostatectomy

Abstract

This case study of LRARP demonstrates that there is sufficient crude evidence to show that this new procedure is likely to be superior to the existing procedure in terms of safety, effectiveness, and cost-effectiveness. The decision to allow MBS funding was correct and will allow for the collection of additional evidence, on both economic and clinical outcomes.

A Systematic Review of Economic Evaluations of the Use of Robotic Assisted Laparoscopy in Surgery Compared with Open or Laparoscopic Surgery

“…Of these, full economic evaluation (i.e. cost-effectiveness, cost-minimisation, cost-utility, cost-benefit analysis) was performed in only six (13 %) [11][12][13][14][15][16]; the remaining articles reported cost analysis. Of note is that in many of these studies effectiveness data were also reported in the same article but these data were not interpreted along with the cost data as they would be in a full economic evaluation.…”

“…Of the 47 studies, 34 (72 %) were conducted in USA , two each in Switzerland (4 %) [51,52], Canada (4 %) [15,53], Ireland (4 %) [14,16] and Australia (4 %) [13,54], and one each in Denmark (2 %) [12], Italy (2 %) [55], Spain (2 %) [56], Sweden (2 %) [57] and the UK (2 %) [11].…”

“…Of these, three studies used outcomes from meta-analysis that included both randomized controlled trials (RCTs) and non-randomised comparative studies measuring final clinical outcomes [11,16,53]. One (2 %) study gathered data from a prospective non-RCT single-centre study they carried out [13] and in one (2 %) study a RCT was conducted [39]. The remaining 34 (72 %) studies gathered clinical-effectiveness data from data registries.…”

“…For the remaining seven (15 %) studies the data came from previously published reports [13,19,20,31,34,35,50].…”

Are Policy Decisions on Surgical Procedures Informed by Robust Economic Evidence? A Systematic Review

“…Three studies were in breast cancer (publication dates 1997 to 2003) (14)(15)(16), seven were in colorectal cancer (publication dates 2000 to 2011) (17)(18)(19)(20)(21)(22)(23) and seven were in prostate cancer (publication dates 2000 to 2012) (24)(25)(26)(27)(28)(29)(30). Two of the three breast cancer studies were set in the United States (14;16), and one was in Norway (15).…”