Journal
INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY
Volume 6, Issue 6, Pages 582-589Publisher
WILEY
DOI: 10.1002/alr.21697
Keywords
chronic sinusitis; health utility; cost effectiveness; endoscopic sinus surgery; disease severity; evidence-based medicine; health care economics; patient reported outcomes; quality of life
Categories
Funding
- Board Committee on Quality at Massachusetts Eye and Ear Infirmary
Ask authors/readers for more resources
BackgroundThe purpose of this work was to evaluate the cost-effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS). MethodsThe study design consisted of a microsimulation Markov decision-tree economic model with a 31-year time horizon. A cohort of 489 patients who underwent ESS for CRS were matched 1 to 1 with a cohort of 489 patients from the national Medical Expenditures Panel Survey database who underwent medical management for CRS. Utility scores were calculated from responses to the EuroQol 5-Dimension instrument in both cohorts. Decision-tree analysis and a subsequent 10-state Markov model utilized published event probabilities as well as primary data from a large multisurgeon prospective outcomes study to calculate long-term costs and utility. The primary outcome measure was incremental cost per quality-adjusted life year (QALY). Multiple sensitivity analyses were performed. ResultsThe incremental cost-effectiveness ratio (ICER) for ESS vs medical therapy alone was $13,851.26 per QALY. The cost effectiveness acceptability curve demonstrated 85.84% and 98.69% certainty that the ESS strategy was the most cost-effective option at willingness-to-pay thresholds of $25,000 and $50,000 per QALY, respectively. ConclusionThis study shows ESS to be a cost-effective intervention compared to medical therapy alone for the management of patients with CRS.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available