Cost-effectiveness of trans-nasal endoscopic sphenopalatine artery ligation vs arterial embolisation for intractable epistaxis: Long-term analyses.
Clin Otolaryngol
; 44(4): 511-517, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-30720918
ABSTRACT
OBJECTIVES:
Trans-nasal endoscopic sphenopalatine artery ligation (TESPAL) and endovascular arterial embolisation both provide excellent success rates for intractable epistaxis. Recent economic models suggest that TESPAL could be a cost-saving strategy. Our main aim was to perform cost-effectiveness analyses on TESPAL compared with embolisation to treat patients with epistaxis.DESIGN:
We performed retrospective, monocentric, comparative analyses on patients referred to our centre and treated with embolisation or TESPAL.SETTING:
This economic evaluation was carried out from a payer's perspective (ie French National Health Insurance) within a time horizon of 12 months.PARTICIPANTS:
Thirty-seven TESPAL procedures and thirty-nine embolisation procedures to treat intractable epistaxis were used in the analyses. MAIN OUTCOMEMEASURES:
The primary outcome is presented as the cost per 1% of non-recurrence. Effectiveness was defined as avoiding recurrence of epistaxis during the 1-year follow-up. Cost estimates were performed from the payer's perspective.RESULTS:
Hospitalisation costs were higher for embolisation compared with TESPAL (5972 vs 3769 euros). On average, hospitalisation costs decreased by 41% when a patient was treated by TESPAL compared with an embolisation strategy (P = 0.06). The presence of comorbidities increased hospitalisation costs by 79% (P = 0.04). TESPAL enabled 1867 to be gained in intractable epistaxis.CONCLUSIONS:
The outcomes from our decision model confirm that TESPAL is more cost-effective for patients with intractable epistaxis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Epistaxe
/
Análise Custo-Benefício
/
Embolização Terapêutica
/
Endoscopia
/
Ligadura
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article