van Roijen I, Nijs H; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1996; 12: 36.

Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands.

OBJECTIVE/PURPOSE: This study analyses costs and effects of treating acouticus neurinoma patients by using microsurgery compared to radiosurgery. Radiosurgery is the stereotatic application of radiotherapy and an innovative medical technology. Cost and effects estimates of the microsurgery were based on a retrospective study in the Netherlands. We investigated the cost-effectiveness in a comparable patient group in Stockholm (Sweden) as if radiosurgery was implimented in the Netherlands. METHODS: 67 acoustic neurinoma patients who had been operated in the University Hospital, Rotterdam, between November of 1990 and January of 1995 were included. This group was compared with 92 acoustic neurinoma patients treated with radiosurgery. Data on health care use were collected from patient files. To obtain data on production losses and quality of Life a questionnaire was sent by mail in Febuary of 1995. This booklet consists of the Health and Labour-questionnaire (HLQ), the Short Form-36 and the EuroQol. RESULTS: The costs for the operation made up 41% of the direct costs. In the case of radiosurgery 70% of the direct costs were due to the treatment. The average length of the total hospital stay of patients treated by microsurgery was 13 days and .5 for radiosurgery. The Dutch patients were absent from work until 3 months after the surgery. Patients treated by radiosurgery were on average absent from work for 1 working week after treatment. General health rating was better for radiosurgery (excellent 16%, (very) good 62%, poor or fair 21%) than for microsurgery (excellent 3%, (very) good 64%, poor or fair 33%, p< 0.01). Also, when measured with the EuroQol, the radiosurgery group scored higher than the microsurgery group. Mean (SD) weighted EuroQol-score 0.88 (0.16) for radiosurgery versus 0.76 (0.20; p< 0.01) for microsurgery. CONCLUSIONS: For the short term, treating patients with an extra-meatal tumor diameter of the acoustic neurinoma less than 3 centimeters with radiosurgery is less costly and more effective than microsurgery. The average direct cost from the day of operation or the day of treatment with radiosurgery were dfl. 21433,= versus dfl. 14126,=. Furthermore, the number of days absent from work and consequently indirect costs were much lower in the radiosurgery group. Additionally, the radiosurgery group has a higher health related quality of life than the microsurgery group.

Publication Types:

• Meeting Abstracts

Keywords:

• Cost-Benefit Analysis
• Humans
• Microsurgery
• Netherlands
• Neuroma, Acoustic
• Radiosurgery
• Retrospective Studies
• Sweden
• economics
• radiotherapy
• surgery
• hsrmtgs

Other ID:

• HTX/97607268

UI: 102222580

From Meeting Abstracts