Cost-utility analysis of open versus laparoscopic groin hernia repair: results from a multicentre randomized clinical trial

McIntosh, E. (2001) Cost-utility analysis of open versus laparoscopic groin hernia repair: results from a multicentre randomized clinical trial. British Journal of Surgery, 8(5), pp. 653-661. (doi:10.1046/j.1365-2168.2001.01768.x)

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Abstract

Background: This study was a pragmatic economic evaluation carried out alongside a multicentre randomized controlled trial comparing laparoscopic with open groin hernia repair. The primary economic evaluation framework employed was a cost–utility analysis. <p/>Methods: At 26 hospitals in the UK and Ireland, 928 patients with a groin hernia were assigned randomly to laparoscopic or open repair. Cost data were identified and measured both within and outwith the trial. Cost data were combined with quality-adjusted life years (QALYs) from the EQ-5D questionnaire to obtain cost-per-QALY ratios. <p/>Results: The mean cost of laparoscopic hernia repair was £1112·64, compared with £788·79 for the open operation. The extra cost of £323·85 in the laparoscopic group was mainly due to additional theatre time and increased equipment and sterilization costs. The estimated incremental cost per QALY of the laparoscopic over the open method was £55 548·00 (95 per cent confidence interval £47 216·00–£63 885·00). <p/>Conclusion: While the results show that a high cost was incurred to produce an additional QALY by using laparoscopic over open hernia repair, sensitivity analyses show that there are specific situations in which laparoscopic repair may be a viable alternative, such as when reusable equipment is employed.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McIntosh, Professor Emma
Authors: McIntosh, E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Arts > School of Critical Studies > Scottish Literature
Journal Name:British Journal of Surgery
ISSN:0007-1323
Published Online:04 December 2002

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