Assumptions on results of meta-analysis the length of hospital stay for treatment (without adverse events) for HoLEP, TURP and OP is two, three and five days respectively. It was assumed that the clinical and other management of patients with BPH up to the time of procedure, as well as post-operative management are equivalent. Based on this assumption, hospital costs for HoLEP procedures were derived based on equivalent TURP costs but adjusted for lengths of stay. For HoLEP treatment, adverse events associated with the procedure, longer-term complications and re-treatment rates were calculated by multiplying the relative risk of experiencing these events by the associated rates for TURP or OP that were derived from the meta-analysis of data. From the published literature it was not possible to determine if a given patient experienced more than one short-term adverse event following treatment. As a result, rates of these events were derived by summing the rates presented in the meta-analysis. As the events and patient numbers that were summed are not necessarily mutually exclusive this may result in an overall over-estimation of rates. Therefore, the overall figures presented for adverse events represent a case’ treatment scenario. ‘worst Adverse events associated with treatment (HoLEP or TURP) would be treated on an basis and result in additional length of hospital stay of two days. Adverse events associated with OP would be treated and resolved within the five day treatment time frame for this intervention. Treatment for longer-term incontinence would include either behavioural interventions, including education programs and lifestyle modifications, or pharmacologic therapy using oxybutynin 5mg twice daily (or equivalent). Treatment for urethral stricture would be performed as an in-patient procedure and undertaken by either urethrotomy or dilation. Patients would not undergo any upon failure of initial urethral stricture treatment. The utility associated with urethral stricture is the same as that for long-term incontinence. Transition probabilities. Rates of short-term adverse events, longer-term side effects and re-treatment associated with TURP were derived from the meta-analysis and are shown in Table 20. All rates were transformed into probability values for use in the model using the formula: P=1-e-rt Where P is the probability that an event will occur; e is the base of the natural logarithm; r is the rate; and t is time.
Assumptions on results of meta-analysis the length of hospital stay for treatment (without adverse events) for HoLEP, TURP and OP is two, three and five days respectively. It was assumed that the clinical and other management of patients with BPH up to the time of procedure, as well as post-operative management are equivalent. Based on this assumption, hospital costs for HoLEP procedures were derived based on equivalent TURP costs but adjusted for lengths of stay. For HoLEP treatment, adverse events associated with the procedure, longer-term complications and re-treatment rates were calculated by multiplying the relative risk of experiencing these events by the associated rates for TURP or OP that were derived from the meta-analysis of data. From the published literature it was not possible to determine if a given patient experienced more than one short-term adverse event following treatment. As a result, rates of these events were derived by summing the rates presented in the meta-analysis. As the events and patient numbers that were summed are not necessarily mutually exclusive this may result in an overall over-estimation of rates. Therefore, the overall figures presented for adverse events represent a ‘worst case’ treatment scenario. Adverse events associated with treatment (HoLEP or TURP) would be treated on an basis and result in additional length of hospital stay of two days. Adverse events associated with OP would be treated and resolved within the five day treatment time frame for this intervention. Treatment for longer-term incontinence would include either behavioural interventions, including education programs and lifestyle modifications, or pharmacologic therapy using oxybutynin 5mg twice daily (or equivalent). Treatment for urethral stricture would be performed as an in-patient procedure and undertaken by either urethrotomy or dilation. Patients would not undergo any upon failure of initial urethral stricture treatment. The utility associated with urethral stricture is the same as that for long-term incontinence. Transition probabilities. Rates of short-term adverse events, longer-term side effects and re-treatment associated with TURP were derived from the meta-analysis and are shown in Table 20. All rates were transformed into probability values for use in the model using the formula: P=1-e-rt Where P is the probability that an event will occur; e is the base of the natural logarithm; r is the rate; and t is time.
1149-Assessment-Report-Final-accessible.docx