MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: A Cost-Effectiveness Evaluation of Surgical Approaches to Proctectomy

Citation Type: Journal Article

Publication Year: 2020

ISSN: 1873-4626

DOI: 10.1007/S11605-020-04615-5

Abstract: Robotic surgery is increasingly used for proctectomy, but the cost-effectiveness of this approach is uncertain. Robotic surgery is considered more expensive than open or laparoscopic approaches, but in certain situations has been demonstrated to be cost-effective. We examined the cost-effectiveness of open, laparoscopic, and robotic approaches to proctectomy from societal and healthcare system perspectives. We developed a decision-analytic model to evaluate one-year costs and outcomes of robotic, laparoscopic, and open proctectomy based on data from the available literature. The robustness of our results was tested with one-way and multi-way sensitivity analyses. Open proctectomy had increased cost and lower quality of life (QOL) compared with laparoscopy and robotic approaches. In the societal perspective, robotic proctectomy costs $497/case more than laparoscopy, with minimal QOL improvements, resulting in an incremental cost-effectiveness ratio (ICER) of $751,056 per quality-adjusted life year (QALY). In the healthcare sector perspective, robotic proctectomy resulted in $983/case more and an ICER of $1,485,139/QALY. One-way sensitivity analyses demonstrated factors influencing cost-effectiveness primarily pertained to the operative cost and the postoperative length of stay (LOS). In a probabilistic sensitivity analysis, the cost-effective approach to proctectomy was laparoscopic in 42% of cases, robotic in 39%, and open in 19% at a willingness-to-pay (WTP) of $100,000/QALY. Laparoscopic and robotic proctectomy cost less and have higher QALY than the open approach. Based on current data, laparoscopy is the most cost-effective approach. Robotic proctectomy can be cost-effective if modest differences in costs or postoperative LOS can be achieved.

Url: https://link.springer.com/article/10.1007/s11605-020-04615-5

User Submitted?: No

Authors: Simianu, Vlad V.; Curran, Thomas; Gaertner, Wolfgang B.; Sklow, Bradford; Kuntz, Karen M; Kwaan, Mary R.; Madoff, Robert D.; Jensen, Christine C.

Periodical (Full): Journal of Gastrointestinal Surgery 2020 25:6

Issue: 6

Volume: 25

Pages: 1512-1523

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop