The cost-effectiveness analysis of drug therapy versus surgery for symptomatic adenoid hypertrophy by a Markov model
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Published:2019-11-28
Issue:3
Volume:29
Page:629-638
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ISSN:0962-9343
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Container-title:Quality of Life Research
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language:en
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Short-container-title:Qual Life Res
Author:
Xiao Han,Huang Jinqiang,Liu Weifeng,Dai Zihao,Peng Sui,Peng Zhenwei,Liang Ruiming,Ma Renqiang,Wen Yihui,Li Jian,Wen Weiping
Abstract
Abstract
Purpose
Adenoid hypertrophy (AH) is common among young children. Adenoid-based surgery and drug therapy could be applied for symptomatic AH patients, yet the treatment decision is difficult to make due to the diverse cost and efficacy between these two treatments.
Methods
A Markov simulation model was designed to estimate the cost-effectiveness (CE) of the adenoid-based surgery and the drug therapy for symptomatic AH patients. Transition probabilities, costs and utilities were extracted from early researches and expert opinions. Simulations using two set of parameter inputs for China and the USA were performed. Primary outcome was cost per QALY gained over a 6-year period. Deterministic and probabilistic sensitivity analyses were also conducted.
Results
The utility for the surgery group and the drug group were 4.10 quality-adjusted life years (QALYs) and 3.58 QALYs, respectively. The cost of the surgery group was more than that of the drug group using model parameters specific to China ($1069.0 vs. $753.7) but was less for the USA ($1994.4 vs. $3977.7). Surgery was dominant over drug therapy when US specific parameters were used. Surgery group had an ICER of $604.0 per QALY when parameters specific to China was used.
Conclusion
Surgery is cost-effective in the simulations for both China and the USA at WTP thresholds of $9633.1 and $62,517.5, respectively.
Funder
National Natural Science Foundation of China Natural Science Foundation of Guangdong Province
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
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