How can robot-assisted surgery provide value for money?. Issue 1 (5th February 2021)

• Record Type: Journal Article
• Authors: Patel, Sejal; Rovers, Maroeska M; Sedelaar, Michiel J P; Zusterzeel, Petra L M; Verhagen, Ad F T M; Rosman, Camiel; Grutters, Janneke P C
• Is Part Of: BMJ surgery, interventions, & health technologies. Volume 3:Issue 1(2021)
• Publication Date: 2021-02-05
• Subjects: health care costs -- health technology -- robotic surgical procedures; Surgery -- Periodicals; Surgery -- Research -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- Periodicals; 617.005
• DOI: 10.1136/bmjsit-2020-000042
• Languages: English
• ISSNs: 2631-4940

Abstract

Abstract : Objectives: To develop an interactive tool that estimates what potential benefits are needed for the robot to provide value for money when compared with endoscopic or open surgical interventions. Design: A generic online interactive tool was developed to analyze the (health) effects needed to compensate for the additional costs of using a surgical robotic system from a healthcare perspective. The application of the tool is illustrated with a hypothetical new surgical robotic platform. A synthesis of evidence from different sources was used combined with interviews with surgeons. Setting: Flexible tool that can be adapted to flexible settings. Participants: Any hospital patient group for which robotic, endoscopic or open surgical procedures may be considered as appropriate treatment alternatives (eg, urology, gynecology, and so on). Intervention: Robotically assisted surgical interventions. Comparator: Endoscopic or open surgical interventions. Main outcome measures: Thresholds of how much (health) effect is needed for robot-assisted surgery to provide value for money and to become cost-effective. Results: The utilization rate of the surgical robotic system and a reduction in complications appeared to be important aspects in determining the value for money. To become cost-effective, it was deemed important for new surgical robotic systems to have added clinical benefit and become less costly than the current system. Conclusions: This paper and its assisting interactive tool can be used by clinicians, researchers, and policymakers to gain insight in the benefit needed to provide value for money when using a (new) surgical robotic system or, when the effects are known or can be estimated, to assess the value for money for a specific indication. For robotic surgery to provide most value for money, we recommend assessing for each indication whether the necessary effects seem achievable.