Economic evaluation of laparoscopic surgery for colorectal cancer

Robyn De Verteuil, Rodolfo Andres Hernandez, Luke David Vale, Aberdeen Health Technology Assessment Group

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: The aim of this study was to assess the cost-effectiveness of laparoscopic surgery compared with open surgery for the treatment of colorectal cancer.

Methods: A Markov model was developed to model cost-effectiveness over 25 years. Data on the clinical effectiveness of laparoscopic and open surgery for colorectal cancer were obtained from a systematic review of the literature. Data on costs came from a systematic review of economic evaluations and from published sources. The outcomes of the model were presented as the incremental cost per life-year gained and using cost-effectiveness acceptability curves to illustrate the likelihood that a treatment was cost-effective at various threshold values for society's willingness to pay for an additional life-year.

Results: Laparoscopic surgery was on average 2300 more costly and slightly less effective than open surgery and had a 30 percent chance of being cost-effective if society is willing to pay 230,000 for a life-year. One interpretation of the available data suggests equal survival and disease-free survival. Making this assumption, laparoscopic surgery had a greater chance of being considered cost-effective. Presenting the results as incremental cost per quality-adjusted life-year (QALY) made no difference to the results, as utility data were poor. Evidence suggests short-term benefits after laparoscopic repair. This benefit would have to be at least 0.01 of a QALY for laparoscopic surgery to be considered cost-effective.

Conclusions: Laparoscopic surgery is likely to be associated with short-term quality of life benefits, similar long-term outcomes, and an additional 300 pound per patient. A judgment is required as to whether the short-term benefits are worth this extra cost.

Original languageEnglish
Pages (from-to)464-472
Number of pages9
JournalInternational Journal of Technology Assessment in Health Care
Volume23
Issue number4
DOIs
Publication statusPublished - 2007

Keywords

  • cost-effectiveness
  • Markov modeling
  • colorectal cancer
  • surgery
  • systematic review
  • randomized clinical-trial
  • open colectomy
  • colon-cancer
  • carcinoma
  • multicenter

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