School of Public Health, Fudan University, Shanghai, 200032, China.
National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
J Robot Surg. 2024 Oct 14;18(1):370. doi: 10.1007/s11701-024-02125-z.
This systematic review aims to summarize the progress made in the study of the cost-effectiveness of robot-assisted radical prostatectomy (RARP) worldwide and to analyze the economic factors influencing this, in an attempt to provide methodological guidance for conducting economic evaluation studies in a domestic context, and to put forward suggestions for improving the cost-effectiveness of RARP in emerging markets. We conducted a systematic literature review and analysis of studies published worldwide from January 2000 to July 2024 concerning the economic evaluation of RARP compared with laparoscopic radical prostatectomy (LRP) or open radical prostatectomy (ORP). A total of 16 papers were included. The literature was generally of good quality. Methodological approaches. varied among studies, leading to inconsistent economic findings. The choice of research settings, including the perspective of the study and time horizon, as well as differences in parameters such as surgical volumes and cost of equipment purchases, were the main factors that affected the cost-effectiveness of RARP. Based on the methodology used in the included studies, we suggest that short-term, localized economic evaluations should be carried out first, based on follow-up studies in emerging markets, whereas long-term economic evaluations can be performed when sufficient data are available. Referring to the analysis of the economic factors influencing cost-effectiveness in the included studies, we suggest that different research settings should be chosen according to the purpose for which policymakers allocate public funds, and that the cost-effectiveness of RARP can be enhanced through technical improvements and resource optimization.
本系统评价旨在总结全球范围内机器人辅助根治性前列腺切除术（RARP）成本效益研究进展，并分析影响其经济性的因素，以期为国内开展经济评价研究提供方法学指导，并为新兴市场中提高 RARP 的成本效益提出建议。我们对 2000 年 1 月至 2024 年 7 月全球范围内关于 RARP 与腹腔镜根治性前列腺切除术（LRP）或开放性根治性前列腺切除术（ORP）的经济学评价的研究进行了系统的文献回顾和分析。共纳入 16 篇文献。文献质量普遍较高。研究方法在不同研究之间存在差异，导致经济结果不一致。研究设置的选择，包括研究的角度和时间范围，以及手术量和设备购置成本等参数的差异，是影响 RARP 成本效益的主要因素。根据纳入研究中使用的方法学，我们建议在新兴市场的随访研究基础上，首先进行短期、局部的经济性评价，而当有足够的数据时，可以进行长期的经济性评价。参考纳入研究中影响成本效益的经济因素分析，我们建议根据决策者分配公共资金的目的选择不同的研究设置，并通过技术改进和资源优化来提高 RARP 的成本效益。
