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Title: Economic evaluation of laparoscopic surgery for colorectal cancer
Authors: De Verteuil, Robyn
Hernández, Rodolfo Andrés
Vale, Luke David
Aberdeen Health Technology Assessment Group
University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Keywords: Colorectal Neoplasma
Economic Evaluation
Markov modelling
Colorectal cancer
Systematic Review
Issue Date: 2007
Publisher: Cambridge University Press
Citation: de Verteuil, R., Hernandez, R., and Vale, L. (2007). Economic evaluation of laparoscopic surgery for colorectal cancer. International Journal of Technology Assessment in Health Care, 23(4), pp.464-472.
Abstract: Objectives: 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 (CEACs) 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 £300 more costly and slightly less effective than open surgery and had a 30% chance of being cost-effective if society is willing to pay £30,000 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 following 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 per patient. A judgement is required as to whether the short-term benefits are worth this extra cost.
ISSN: 0266-4623
Appears in Collections:Applied Health Sciences research
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