Authors' objectives: Based on the 2nd Generation NHI Act 42, health technology assessment (HTA) may be performed on new medical services (diagnostics and procedures) at the time of making reimbursement decisions. In addition to the considerations of human health, medical ethics, cost-effectiveness and health insurance finance are also major issues. Therefore, the aim of this study is to perform a comprehensive evaluation of these emerging treatments including bipolar TURP, bipolar TUVP (vaporization of the prostate), Green Light TM, thulium, holmium, and diode laser prostatectomy. The efficacy and economic literature of 6 surgical procedures was collected and synthesized by systematic review. The report UK, Canada and Australia, as well as international experience through the network of INAHTA were assessed. In addition, domestic status such as clinical application, distribution, prices, and cost analysis was investigated through questionnaires and qualitative interview.

Authors' results and conclusions: Our research found that most evidence is related to the comparison of bipolar and monopolar TURP. Cost-utility analysis with a Markov model framework was conducted to evaluate the cost-effectiveness of these procedures. Our evaluation concludes that bipolar TURP appears to be comparable effective and safer (reduction of TUR syndrome by 78%) in compared to monopolar TURP. The results also showed that the bipolar TURP maybe a cost-effective option. If this procedure is included in the NHI, the budget impact was estimated to be about 50 million to 200 million NTD.

Authors' recommendations: The assessment results shown above in respect of several dimensions could be served as an important information for decision makers of NHIA to appraise the value of transurethral prostate surgeries in Taiwan and then make decisions on reimbursement or not.

Authors' methods: Therefore, the aim of this study is to perform a comprehensive evaluation of these emerging treatments including bipolar TURP, bipolar TUVP (vaporization of the prostate), Green Light TM, thulium, holmium, and diode laser prostatectomy. The efficacy and economic literature of 6 surgical procedures was collected and synthesized by systematic review. The report UK, Canada and Australia, as well as international experience through the network of INAHTA were assessed. In addition, domestic status such as clinical application, distribution, prices, and cost analysis was investigated through questionnaires and qualitative interview.

Project Status: Completed

Year Published: 2020

URL for published report: https://www.cde.org.tw/

Requestor: National Health Insurance Administration

English language abstract: An English language summary is available

Publication Type: Full HTA

Organisation Name: Center for Drug Evaluation

Contact Address: 3F.,No.465, Sec.6, Zhongxiao E. Rd., Taipei 11557, Taiwan. R.O.C.

Contact Name: Li Ying (Grace) Huang

Contact Email: lyhuang277@cde.org.tw