Poley MJ, Stolk EA, Langemeijer RA, Molenaar JC, Busschbach JJ; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2000; 16: 281.

Institute for Medical Technology Assessment, Erasmus University Rotterdam; The Netherlands

Introduction: Evidence about the cost-effectiveness of neonatal surgery is lacking. However, the fear exists that neonatal surgery might save lives only at the price of severe impairments. For instance, congenital anorectal malformation (CAM) is a complex anomaly, and the success of surgery in restoring normal defecation is limited. Hence, the question is raised how effects relate to the costs from a societal point of view. Methods: We performed a study in patients who underwent treatment for CAM in the Sophia Children's Hospital in Rotterdam. Both direct and indirect, medical and non-medical costs were analyzed. We used the technique of the cost-utility analysis; utilities were measured with the EuroQol eQ-5D. Both costs and effects were estimated for a life long setting. A comparison was made with a 'doing nothing' scenario. We assumed that the comparator 'doing nothing' would bring about death in half the patients; the other half would survive with substantially impaired quality of life however (equal to an EuroQol value of 0.50). Both costs and effects are discounted at 5%. Results: 411 questionnaires were sent; the response rate was 68,9% (n= 283). The mean life expectancy at birth of the CAM patients amounts to 67.0 years. The eQ-5D demonstrates that the quality of life is only limited impaired compared to that of the general population (0.88 versus 0.93). The total costs of treatment for CAM are estimated at fl. 69,622. Treatment for CAM compared to 'doing nothing' results in a gain of 12.7 QALYs. The costs per QALY are US $ 2551. Conclusions: The costs of treatment for CAM are high, but can be accounted for by the effects. The cost-effectiveness is favorable compared to other treatments. Given the fear that CAM treatment might save lives only at the price of severe impairments, this empirical evidence is reassuring.

Publication Types:

• Meeting Abstracts

Keywords:

• Child
• Cost-Benefit Analysis
• Costs and Cost Analysis
• Humans
• Mastectomy
• Mastectomy, Segmental
• Quality-Adjusted Life Years
• Questionnaires
• Radiotherapy, Adjuvant
• abnormalities
• economics
• radiotherapy
• surgery
• therapy
• hsrmtgs

Other ID:

• GWHSR0000298

UI: 102271972

From Meeting Abstracts