An analysis of benign prostatic hyperplasia surgical treatment reimbursement trends across Canada: Examining provincial changes over the recent decade with comparison to cost of living changes.

A variety of procedures for the endoscopic surgical treatment of symptomatic benign prostatic hyperplasia (BPH) refractory to medical therapy have existed for decades. The present study examines trends in surgeon compensation for these treatments within Canada.

The physician fee schedule for BPH surgery across 10 Canadian provinces for the years 2010 and 2023 were obtained. A descriptive study examining first, the provincial reimbursement for transurethral resection of prostate (TURP) and laser ablative/enucleation surgery; second, the difference in TURP reimbursement between 2010 and 2023; and third, the annual change in TURP reimbursement juxtaposed with the annual change in the provincial Consumer Price Index (CPI) and annual salary for the working population aged 35-44.

Seven of 10 Canadian provinces reimburse laser BPH surgery equally to TURP. The average provincial TURP reimbursement is $545, ranging from $451 in Ontario to $688 in Saskatchewan. Since 2010, TURP reimbursement has varied by province from a 0% net change in Ontario to an increase of 21% in Nova Scotia. Reimbursement for TURP has increased at a slower pace than the local CPI, and for half of the provinces at a slower pace than the annual salary for people aged 35-44.

The compensation model for endoscopic BPH surgery does not have a unified structure in Canada that is consistent across provinces, nor does it keep up with inflation, possibly impacting future recruitment, increasing geographic disparities, and most importantly, limiting the adoption of new BPH therapies.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2024 Apr 02 [Epub ahead of print]

Anindyo Chakraborty, Dean S Elterman, Nicholas Corsi, David Bouhadana, Gregory Bailly, Premal Patel, Rowen McLellan, Liam Hickey, Daniel Costa, Matthew Andrews, Howard Evans, Connor M Forbes, Hazem Elmansy, Malek Meskawi, Naeem Bhojani, Bilal Chugtai, Kevin C Zorn

Faculty of Medicine and Health Sciences, McGill University, Montreal, QC; Canada., Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada., Wayne State University School of Medicine, Detroit, MI, United States., Division of Urology, McGill University, Montreal, QC, Canada., Department of Urology, Dalhousie University, Halifax, NS Canada., Section of Urology, University of Manitoba, Winnipeg, MB, Canada., Division of Urology, Queen Elizabeth Hospital, Charlottetown, PEI, Canada., Division of Urology, Memorial University, St. John's, NL, Canada., Division of Urology, University of Alberta, Edmonton, AB, Canada., Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada., Department of Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada., Department of Urology, Université de Montréal, Montreal, QC, Canada., Department of Urology, Weill Cornell Medicine, New York, NY, United States.