Izvorni znanstveni članak
Stapled hemorrhoidopexy, an innovative surgical procedure for hemorrhoidal prolapse: cost-utility analysis
Goran Ribarić
orcid.org/0000-0002-2292-3004
; European Surgical Institute Ethicon Endo-Surgery (Europe) GmbH, Johnson&Johnson, Norderstedt, Germany
Justus Kofler
; European Surgical Institute Ethicon Endo-Surgery (Europe) GmbH, Johnson&Johnson, Norderstedt, Germany
David G. Jayne
; St. James’s University Hospital, Leeds, United Kingdom
Sažetak
Aim To undertake full economic evaluation of stapled
hemorrhoidopexy (PPH) to establish its cost-effectiveness
and investigate whether PPH can become cost-saving
compared to conventional excisional hemorrhoidectomy
(CH).
Methods A cost–utility analysis in hospital and health care
system (UK) was undertaken using a probabilistic, cohortbased
decision tree to compare the use of PPH with CH.
Sensitivity analyses allowed showing outcomes in regard
to the variations in clinical practice of PPH procedure.
The participants were patients undergoing initial surgical
treatment of third and fourth degree hemorrhoids within
a 1-year time-horizon. Data on clinical effectiveness were
obtained from a systematic review of the literature. Main
outcome measures were the cost per procedure at the
hospital level, total direct costs from the health care system
perspective, quality adjusted life years (QALY) gained
and incremental cost per QALY gained.
Results A decrease in operating theater time and hospital
stay associated with PPH led to a cost saving compared to
CH of GBP 27 (US $43.11, €30.50) per procedure at the hospital
level and to an incremental cost of GBP 33 (US $52.68,
€37.29) after one year from the societal perspective. Calculation
of QALYs induced an incremental QALY of 0.0076
and showed an incremental cost-effective ratio (ICER) of
GBP 4316 (US $6890.47, €4878.37). Taking into consideration
recent literature on clinical outcomes, PPH becomes
cost saving compared to CH for the health care system.
Conclusions PPH is a cost-effective procedure with an
ICER of GBP 4136 and it seems that an innovative surgical
procedure could be cost saving in routine clinical practice.
Ključne riječi
Hrčak ID:
71467
URI
Datum izdavanja:
15.8.2011.
Posjeta: 1.542 *