Photoselective GreenLight™ laser vaporization versus transurethral resection of the prostate in Greece: a comparative cost analysis.

PURPOSE To compare photoselective vaporization of the prostate (PVP) using the 120W GreenLight™ laser with transurethral resection of the prostate (TURP) in terms of their cost to the Greek National Health Service (NHS) or to the Public Insurance Sickness Funds (PISF). PATIENTS AND METHODS A prospective cost evaluation with 1-year follow-up of 60 patients with infravesical obstruction of benign prostatic hyperplasia origin who underwent o either TURP (n=30) or PVP (n=30). The cost of equipment, consumables, anesthesia, drugs, inpatient hospitalization, and complication management within 1 year postoperatively were used to calculate the cost for the NHS. PISF reimbursements to hospitals and PISF opportunity cost from the lost days of work were used to calculate PISF perspective. RESULTS From the NHS perspective, the average cost was €1722 ($2371) for PVP and €2132 ($2935) for TURP. From the PISF perspective, the average cost for hospital reimbursement was €1348 ($1856) in the case of PVP and €938 ($1291) in the case of TURP. Nevertheless, in the case of patients still working, total PISF reimbursement cost was €2038 ($2806) for PVP and €2666 ($3671) for TURP. CONCLUSIONS PVP for 40 to 70 cc prostates is preferable from the perspective of the NHS. From the perspective of PISF, PVP is less costly only in the case of patients who are still working, because patients who undergo PVP stay much less out of work. Further investigation in larger populations as well as in different protocols of PVP hospitalization and return to work times is deemed necessary to reinforce the conclusions of this study.