Economic Evaluations of Robotic-Assisted Surgery: Methods, Challenges and Opportunities

Tzu-Jung Lai (), Robert Heggie, Hanin-Farhana Kamaruzaman, Janet Bouttell and Kathleen Boyd
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Tzu-Jung Lai: University of Glasgow
Robert Heggie: University of Glasgow
Hanin-Farhana Kamaruzaman: University of Glasgow
Janet Bouttell: University of Glasgow
Kathleen Boyd: University of Glasgow

Applied Health Economics and Health Policy, 2025, vol. 23, issue 1, No 4, 35-49

Abstract: Abstract Background The use of robotic-assisted surgery (RAS) is growing rapidly. However, economic evaluation of this technology is challenging. This study aims to identify and discuss the different economic evaluation methods which have been used to evaluate RAS. Method This scoping review systematically searched PubMed and Embase from 2015 to 2023. We included economic evaluation studies comparing RAS versus laparoscopic or open surgery. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to aid data extraction and was extended to cover additional features relevant to RAS, including learning curve, organisational impact, incremental innovation and dynamic pricing. Results A total of 50 economic evaluations of RAS were included. Cost-utility analysis (46%) was the most commonly applied economic evaluation method, followed by cost-consequence analysis (32%). The studies focused on the specialties of urology (42%), hepato-pancreato-biliary (20%), colorectal (14%) and gynaecology (6%). Distinctive features related to the assessment of RAS were under-addressed in economic evaluations. Only 40% of the included studies considered learning curve and organisational impact and less than 12% of the included studies reflected on incremental innovation and dynamic pricing. Conclusions This review found that some studies have incorporated challenges specific to RAS in their evaluations. However, most studies still lack key aspects of importance. In particular, studies rarely considered the ability of RAS platforms to be shared across multiple specialities. Incorporating these distinctive features offers an opportunity for economic evaluation to provide decision-makers with a more realistic assessment of the cost-effectiveness of this technology and to ensure its optimal utilisation in clinical practice.

Date: 2025
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DOI: 10.1007/s40258-024-00920-1

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