A cost-effectiveness analysis of delayed breast reconstruction with pedicled flaps from the back.
J Plast Reconstr Aesthet Surg
; 75(7): 2211-2218, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35365412
ABSTRACT
BACKGROUND:
Variability in breast reconstruction methods provides an opportunity to investigate whether a method is superior to another with regard to cost, quality, or both. We performed a cost-effectiveness analysis (CEA) study based on tertiary endpoint data from a randomized clinical trial to compare the cost-effectiveness of delayed breast reconstruction by either a latissimus dorsi flap (LD) or a thoracodorsal artery perforator flap (TAP). MATERIAL &METHODS:
A total of 50 women were included for unilateral delayed breast reconstruction and were randomized to reconstruction by either the LD flap (n = 18) or the TAP flap (n = 22). The CEA was based on differences in shoulder function after the reconstruction. Direct and indirect costs relating to the two procedures were assessed by the Danish Diagnosis-Related Groups tariffs.RESULTS:
Our analysis showed a significant positive effect of introducing the TAP flap on the total shoulder score with an additional cost of $2779. The incremental cost-effectiveness ratio was $4481 and based on a willingness to pay (WTP) $500, we found an estimated net benefit of $519, which was statistically significant (p = 0.0375). The cost-effectiveness acceptability curve indicated that there is a 96.3% probability for the TAP flap being cost-effective to the LD flap at a WTP threshold of $500.CONCLUSION:
From a societal perspective, our cost-effective analysis demonstrated that the TAP flap is the more cost-effective method of breast reconstruction compared to the LD flap with respect to patient-reported shoulder-related disability.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Mamoplastia
/
Retalho Perfurante
/
Músculos Superficiais do Dorso
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Aspecto:
Patient_preference
Limite:
Female
/
Humans
Idioma:
En
Revista:
J Plast Reconstr Aesthet Surg
Ano de publicação:
2022
Tipo de documento:
Article