Cost of radiofrequency ablation in the treatment of hepatic malignancies

Objectives - 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). Patients and 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 € 1581 (group Ia), € 3824 (group Ib), € 8194 (group II) and € 12967 (group III). Costs per stay without intensive care in these groups were respectively € 1581, € 3635, € 6622 and € 10905 and reimbursement (intensive care excluded) was € 560, € 3367, € 9084 and € 11780. Conclusion - 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.