Cost-Utility Analysis of Robotic-Assisted Radical Cystectomy

Bladder cancer is the second most common cancer of the urogenital tract. Radical cystectomy is the most reliable treatment method for infiltrating and aggressive tumors, and it can be performed using different surgical approaches. The aim of this study is to perform a clinical and economic evaluation and comparison of two surgical approaches to bladder cancer: robotic-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). The study analysed direct medical costs from the perspective of both the healthcare payer and facility. It conducted a cost-utility analysis and presented the results as an incremental cost-utility ratio (ICUR) using quality-adjusted life-years (QALY). Uncertainty was assessed through one-way sensitivity analysis. The ICUR from the healthcare payer's perspective is 1,485,211 CZK/QALY, and from the healthcare facility's perspective, it is 1,186,048 CZK/QALY. The study indicates that RARC is not cost-effective for healthcare payers. The cost-effectiveness of healthcare facilities depends on the value of the willingness-to-pay threshold.