The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer
Open Access
- 18 April 2013
- Vol. 3 (4), e001884
- https://doi.org/10.1136/bmjopen-2012-001884
Abstract
Objective To summarise how costs and health benefits will change with the adoption of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer. Design Cost-effectiveness modelling using the information from a randomised controlled trial. Participants Two hypothetical modelled cohorts of 1000 individuals undergoing total laparoscopic hysterectomy and total abdominal hysterectomy. Outcome measures Surgery costs; hospital bed days used; total healthcare costs; quality-adjusted life years; and net monetary benefits. Results For 1000 individuals receiving total laparoscopic hysterectomy surgery, the costs were $509 575 higher, 3548 hospital fewer bed days were used and total health services costs were reduced by $3 746 221. There were 39.13 more quality-adjusted life years for a 5 year period following surgery. Conclusions The adoption of total laparoscopic hysterectomy is almost certainly a good decision for health services policy makers. There is 100% probability that it will be cost saving to health services, a 86.8% probability that it will increase health benefits and a 99.5% chance that it returns net monetary benefits greater than zero.This publication has 23 references indexed in Scilit:
- Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: Results from a randomised controlled trialEuropean Journal Of Cancer, 2012
- Recurrence and Survival After Random Assignment to Laparoscopy Versus Laparotomy for Comprehensive Surgical Staging of Uterine Cancer: Gynecologic Oncology Group LAP2 StudyJournal of Clinical Oncology, 2012
- Cost effectiveness of laparoscopy versus laparotomy in early stage endometrial cancer: A randomised trialGynecologic Oncology, 2011
- Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trialThe Lancet Oncology, 2010
- Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomised trialThe Lancet Oncology, 2010
- Quality of Life of Patients With Endometrial Cancer Undergoing Laparoscopic International Federation of Gynecology and Obstetrics Staging Compared With Laparotomy: A Gynecologic Oncology Group StudyJournal of Clinical Oncology, 2009
- Laparoscopy Compared With Laparotomy for Comprehensive Surgical Staging of Uterine Cancer: Gynecologic Oncology Group Study LAP2Journal of Clinical Oncology, 2009
- International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?Health Economics, 2009
- Total laparoscopic versus open surgery for stage 1 endometrial cancer: The LACE randomized controlled trialContemporary Clinical Trials, 2006
- Cancer Statistics, 2005CA: A Cancer Journal for Clinicians, 2005