Intra-Procedure Cost Variability: A Retrospective Analysis of Real-World Patient Level Information Costing (PLICS) Data for a Minimally Invasive BPO Therapy in the NHS
Author(s)
Alex Zervakis, BSc Hons1, Joshua Hicks, BSc2, Mark Rochester, MA MB BChir MD MRCS FRCS(Urol)3.
1Olympus Europa SE & Co. KG, Hamburg, Germany, 2Olympus UK & Ireland, Southend-on-Sea, United Kingdom, 3Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
1Olympus Europa SE & Co. KG, Hamburg, Germany, 2Olympus UK & Ireland, Southend-on-Sea, United Kingdom, 3Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
OBJECTIVES: With incidence rising, the growing economic burden of benign prostatic obstruction (BPO), a condition affecting ageing men, highlights the need to evaluate the cost of healthcare delivery. One such treatment option is a minimally invasive surgical therapy (MIST), the temporary implantable nitinol device (temporary device). Our research evaluates intra-procedural cost variance amongst a cohort of patients treated with the temporary device within the NHS in England.
METHODS: Clinical records were searched from 2023-2025 for patients treated with the temporary device at Norfolk and Norwich University Hospital. Among the 22 patients treated, complete PLICS data were available for 16. Baseline demographics, perioperative theatre time, segmented costs and total episode costs were evaluated using descriptive statistics. Costs were compared to reference values for alternative BPO MISTs.
RESULTS: Median (IQR) patient age was 68.5 (20) years and median prostate volume was 30 (22) ml. Median total episode cost was £1,003 (£510), ranging from £589 to £2,757. Median theatre, recovery and ward time were 11 (4.8), 46 (21.3) and 492.5 (151.3) minutes respectively. On average, theatre costs accounted for 63% of total episode cost. Compared to reference costs for other BPO MISTs, the temporary device procedure cost was 68.6% lower (£1,003 vs £3,191). The cost of the temporary device itself however was not included in the PLICS data.
CONCLUSIONS: Our analysis showed that even in a small cohort, intra-procedure cost variability can be substantial. The lowest cost was observed in a patient treated under local anaesthetic, whilst the highest cost patient required two nights stay in hospital. Standardising treatment protocols, and utilising local anaesthesia and same-day discharge where clinically safe and appropriate, may help reduce treatment cost. There was no obvious correlation between baseline demographics and episode cost. Further research requires larger sample sizes, should incorporate device costs and assess overall cost-effectiveness.
METHODS: Clinical records were searched from 2023-2025 for patients treated with the temporary device at Norfolk and Norwich University Hospital. Among the 22 patients treated, complete PLICS data were available for 16. Baseline demographics, perioperative theatre time, segmented costs and total episode costs were evaluated using descriptive statistics. Costs were compared to reference values for alternative BPO MISTs.
RESULTS: Median (IQR) patient age was 68.5 (20) years and median prostate volume was 30 (22) ml. Median total episode cost was £1,003 (£510), ranging from £589 to £2,757. Median theatre, recovery and ward time were 11 (4.8), 46 (21.3) and 492.5 (151.3) minutes respectively. On average, theatre costs accounted for 63% of total episode cost. Compared to reference costs for other BPO MISTs, the temporary device procedure cost was 68.6% lower (£1,003 vs £3,191). The cost of the temporary device itself however was not included in the PLICS data.
CONCLUSIONS: Our analysis showed that even in a small cohort, intra-procedure cost variability can be substantial. The lowest cost was observed in a patient treated under local anaesthetic, whilst the highest cost patient required two nights stay in hospital. Standardising treatment protocols, and utilising local anaesthesia and same-day discharge where clinically safe and appropriate, may help reduce treatment cost. There was no obvious correlation between baseline demographics and episode cost. Further research requires larger sample sizes, should incorporate device costs and assess overall cost-effectiveness.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE559
Topic
Economic Evaluation, Medical Technologies, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Urinary/Kidney Disorders