Cost of radiofrequency ablation in the treatment of hepatic malignancies.
OBJECTIVE
Our primary objective was to assess the cost of radio-frequency ablation (RFA) of hepatic malignancies and to compare it to hospital reimbursement paid in the French Prospective Payment System (PPS).


METHODS
A series of 305 patients were enrolled into a prospective study. All resources used during the RFA-related hospital stay were recorded. Costs were assessed from the perspective of the health care providers and computed for four groups of patients: percutaneous RFA in an outpatient setting (group Ia, N=44), percutaneous RFA in an inpatient setting (group Ib, N=94), laparoscopic RFA (group II, N=44) and intraoperative RFA combined with resection (group III, N=120).


RESULTS
Mean hospital costs were estimated at euro 1581 (group Ia), euro 3824 (group Ib), euro 8194 (group II) and euro 12967 (group III). Costs per stay without intensive care in these groups were respectively euro 1581, euro 3635, euro 6622 and euro 10905 and reimbursement (intensive care excluded) was euro 560, euro 3367, euro 9084 and euro 11780.


CONCLUSIONS
In the French PPS, the cost of RFA is covered by lump sums paid to hospitals exclusively for intraoperative and laparoscopic RFA. For percutaneous RFA, which is the most frequent approach, reimbursement is highly insufficient.
Bonastre
Julia
J
Department of Health Economics, Gustave Roussy Institute, 39 rue Camille-Desmoulins, Villejuif Cedex. bonastre@igr.fr
De Baère
Thierry
T
Elias
Dominique
D
Evrard
Serge
S
Rouanet
Philippe
P
Bazin
Christophe
C
Giovannini
Marc
M
Delpero
Jean Robert
JR
De Pouvourville
Gérard
G
Marchal
Frédéric
F
D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000601:surgery; D017115:Catheter Ablation / Q000191:economics*; D005260:Female; D005602:France; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008113:Liver Neoplasms / Q000191:economics* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012051:Reimbursement Mechanisms