Convective water vapor thermal therapy (WVTT; Rezūm System) is an emerging minimally invasive surgical procedure for the treatment of lower urinary tract symptoms (LUTs) due to benign prostatic hyperplasia (BPH). In Canada, WVTT is not available in the public health care system nor is it covered by private health plans. It is only available to men suffering from moderate-to-severe BPH willing to pay out of pocket $5,900 CAD for the procedure. The aim of this study was to assess the willingness to pay (WTP) of patients who underwent WVTT in a Toronto urological clinic.

An online survey was developed using Microsoft Forms (Redmond, WA) and distributed to 170 patients who underwent a WVTT procedure between April 2019 and November 2020. The ethical committee approval was provided by University of Toronto’s research ethics committee before the study execution. All patients who received the survey invite provided consents to participate in research on their WVTT procedural date. The survey questionnaire was adapted from a previously validated methodology on WTP in published research and included questions about their demographic characteristic and WTP for the WVTT procedure. The WTP question was “Looking back at your Rezūm procedure and how you are doing today, what is the MOST money you would be willing to pay for the Rezūm procedure?” The questionnaire was pilot tested and revised based on participants’ comments. A follow-up reminder was sent to all patients two weeks post-initial email invite to increase response rates.

A total of 128 patients responded to the survey (75% response rate). The mean age of the respondents was 67 (SD=8). More than half (88%) of the respondents were white, 83% married, and 66% had a gross household income of ≥$100,000 CAD. Among 127 patients who answered the WTP question, the mean WTP for the WVTT procedure was $6,330 CAD (95%CI $4,776, $7,883). Overall, 42% of men surveyed reported they were willing to pay more than $5,900 CAD, the actual price of the WVTT procedure, when looking back on their procedure (Figure).

Nearly half of men suffering from moderate-to-severe LUTs due to BPH and underwent WVTT were willing to pay more than the actual price of the procedure demonstrating the meaningful monetary value of the technology to the patients.

In a healthcare system in which nearly all treatment options for BPH are paid for by the public Medicare system with no cost to the patient, men in this study on average were willing to pay $6,330 CAD out of pocket for WVTT.