Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost

Abstract

Objective To describe national trends, predictors, insurance, and patient costs associated with sedation use during prostate biopsies. Methods We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes. Biopsy type, anesthesia claims, comorbidities, and magnetic resonance imaging (MRI) use were determined through current procedural terminology/International Classification of Diseases 10th revision codes. Multivariable logistic regression assessed predictors of sedation use. Out-of-pocket costs were calculated by summing insurance copays, deductibles, and coinsurance, adjusted to 2021 dollars. Results The final cohort included 172,148 prostate biopsies. The mean patient age was 62 ± 8 years. The proportion of biopsies performed with sedation increased from 15.6% in 2016 to 25.5% in 2021. Saturation biopsies were 9 times more likely to involve sedation than systematic biopsies (OR = 9.02, 98% CI = 8.18-9.95, P