Cost Effectiveness of the Use of Prophylactic Mesh To Prevent Parastomal Hernia After Urinary Diversion with an Ileal Conduit

Saha, Sanjib; Gerdtham, Ulf G.; Bläckberg, Mats; Kollberg, Petter

doi:10.1016/j.euros.2022.03.011

Cited by 6 publications

(2 citation statements)

References 17 publications

(16 reference statements)

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“…Uncertainty regarding incremental costs and effects was assessed using non-parametric bootstrapping with 5000 replications [ 7 ]. For this purpose, a multivariable logistic regression was performed following Saha et al [ 12 ], with the dependent variable “alive at 5 years” or “dead within 5 years” and the independent variables age, sex, site, clinical stage, and treatment group. The bootstrapped cost-effectiveness pairs were presented in a four-quadrant cost-effectiveness (CE)-plane with the differences between the intervention and the base-case regimen in effect on the x-axis and the difference in total cost on the y-axis [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Cost-effectiveness Analysismentioning

confidence: 99%

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Cost-effectiveness analysis of (accelerated) pre-operative versus (conventional) post-operative radiotherapy for patients with oral cavity cancer in Sweden

et al. 2023

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Background Treatment for resectable oral cavity cancer (OCC) often includes combinations of surgery and radiotherapy (RT), but there is no conclusive information on the preferred treatment order. The aim of this study was to assess the costs and cost-effectiveness of two alternative treatment regimens for patients with OCC, reflecting pre- and post-operative RT, from a societal perspective. Methods The study used data from the ARTSCAN 2 randomised controlled trial, which compares pre-operative accelerated RT with post-operative conventionally fractionated RT. Two-hundred-forty patients were included in the analysis of treatment outcomes. Direct costs were retrieved from the hospital’s economic systems, while indirect costs were obtained from national registries. Cost-effectiveness was assessed and a sensitivity analysis was performed. Overall survival (OS) at 5 years, was used as effect measure in the analysis. Results Two-hundred-nine patients completed the treatments and had retrievable data on costs. Mean direct costs (inpatient and outpatient care) were € 47,377 for pre-operative RT and € 39,841 for post-operative RT (p = 0.001), while corresponding indirect costs were € 19,854 and € 20,531 (p = 0.89). The incremental cost, i.e., the mean difference in total cost between the treatment regimens, was € 6859 paralleled with a 14-percentage point lower OS-rate at 5 years for pre-operative RT (i.e., 58 vs. 72%). Thus, pre-operative RT was dominated by post-operative RT. Conclusions From a societal perspective, post-operative RT for patients with resectable OCC is the dominant strategy compared to pre-operative RT.

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Section: Methodsmentioning

confidence: 99%

Section: Cost-effectiveness Analysismentioning

confidence: 99%