Authors' recommendations:
               The Ontario Health Technology Advisory Committee (OHTAC) reviewed and accepted the
findings of the health technology assessment conducted by Health Quality Ontario.
The committee's recommendations were based on several factors. First, there is no high-quality evidence that the robotic surgical system results in a higher cure rate when compared with open prostatectomy. There is also no high-quality evidence that the use of the robotic surgical system results in lower rates of urinary incontinence or erectile dysfunction. Although some studies did suggest improved outcomes with the use of the robotic surgical system, these studies had serious limitations. Second, based on the economic evaluation in the health technology assessment, the Ontario Health Technology Advisory Committee felt that the robotic surgical system does not provide good value for money.
The committee also discussed the diffusion of the technology in Ontario and other jurisdictions, the impact on education and training in urology, as well as other surgical specialties. The committee was also influenced by the fact that in many jurisdictions, including in Ontario, current funding for the radical prostatectomy procedure is the same irrespective of the surgical approach. The committee felt that this policy should continue, and therefore decided to recommend against publicly funding the robotic surgical system for radical prostatectomy.
Finally, the committee carefully considered the feedback that was received regarding the draft
recommendation before making a final recommendation.