Abstract
Prostatic artery embolization (PAE) is effective in reducing lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) in larger prostates (>80 mL). There are limited surgical options for prostates of this size including simple prostatectomy (SP) (1). One of the factors that should be considered when choosing a treatment option is cost. The purpose of this study was to compare charges and Medicare reimbursement for PAE vs simple prostatectomy. Medicare patients with BPH, LUTS and prostate volume greater than 80ml who underwent either PAE or simple prostatectomy from 2016 to 2018 at a single academic medical center were identified from the electronic medical record. Patients were excluded if they underwent PAE for hematuria or had additional procedures at the time of their prostatectomy. Data collected included total charges including hospital and professional components, Medicare reimbursement and duration of hospital stay. Additional reimbursement from supplemental insurance policies was not included in the analysis. After using the inclusion/exclusion criteria described above, 8 PAE patients and 5 SP patients were included. The mean prostate volume was 107mL and 171mL for the PAE and SP patients, respectively. The median nights spent in the hospital was 0 and 1 for the PAE and SP patients, respectively. For the PAE cohort, mean hospital charges were $16,734 and mean professional charges were $16,163. For the SP cohort, mean hospital charges were $22,395 and mean professional charges were $8,571. Mean total charges were $32,896 and $ 30,966 for the PAE patients and SP patients, respectively. Mean total Medicare reimbursement for both the hospital and professional charges was $9,061 for the PAE patients and $15,202 for the SP patients. When compared to simple prostatectomy, PAE is associated with significantly lower hospital charges as well as lower Medicare payment values. This information is useful when making public health treatment policy decisions regarding BPH patients with very enlarged prostates.
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