Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy – A quality of life and cost effectiveness analysis

The Surgeon ◽  
2016 ◽  
Vol 14 (5) ◽  
pp. 260-264 ◽  
Author(s):  
John P. Gibbons ◽  
Emmeline Nugent ◽  
Nollaig O'Donohoe ◽  
Barry Maher ◽  
Bridget Egan ◽  
...  
2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 135-140 ◽  
Author(s):  
G Marsden ◽  
D Wonderling

Background: Cost-effectiveness analysis (CEA) is often misperceived to be a cost-cutting exercise. The intention of CEA is not to identify and implement cheap technologies, but rather those which offer maximum health gain, subject to available funds. Such analysis is crucial for decision making in health care, as tight budget constraints mean spending in one area of healthcare displaces spending elsewhere. Therefore in order to achieve the greatest health gain for the overall population, treatments must be selected which provide the greatest health gain within the available funds. Summary: The relevance of CEA in health care systems is explained, using varicose vein treatment in the UK NHS as an example. Treatment for varicose veins is often not commissioned to at a local level, most likely because it is misperceived to be a cosmetic problem. However, this view does not take into account the impact of quality of life. CEA balances costs against a quantitative measure of health related quality of life, and could therefore be used to determine whether it is cost-effective to provide varicose vein treatment. The current literature on the cost-effectiveness of varicose vein treatment is reviewed, and an overview of cost-effectiveness principles is provided. Concepts such as economic modelling, incremental cost-effectiveness ratios (ICERs), net monetary benefit (NMB) and sensitivity analysis are explained, using examples relevant to varicose veins where appropriate. Conclusion: This article explains how, far from cutting costs and sacrificing patient health, CEA provides a useful tool to maximise the health of the population in the face of ever tightening budget constraints. CEA could be used to compare the cost-effectiveness of the various treatment options for varicose veins, and efficiencies realised.


Kontakt ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 128-136 ◽  
Author(s):  
Irena Drugdová ◽  
Vladimír Rogalewicz ◽  
Martin Šrámek ◽  
Veronika Kopalová ◽  
Ondřej Krahula ◽  
...  

2000 ◽  
Vol 43 (12) ◽  
pp. 1695-1701 ◽  
Author(s):  
Alexander R. Miller ◽  
Scott B. Cantor ◽  
George E. Peoples ◽  
David B. Pearlstone ◽  
John M. Skibber

Endoscopy ◽  
2021 ◽  
Author(s):  
Dhairya L Mehta ◽  
Adam Loutfy ◽  
Vladimir M Kushnir ◽  
Ashley Faulx ◽  
Zachary L Smith

Background and Study Aims: For large sessile colorectal polyps (LSCPs), endoscopic mucosal resection without diathermy (“cold EMR”) is gaining popularity due to its safety advantages over conventional EMR (“hot EMR”). Polyp recurrence rates have been reported to be higher with cold EMR. Considering these differences, we performed a cost-effectiveness analysis of these two techniques. Patients and Methods: A decision analysis model was constructed, for EMR of a LSCP. The decision tree incorporated EMR method, clip use, procedural mortality, adverse events and their management, and polyp recurrence. Quality of life was measured in terms of days of lost productivity. Adverse event and recurrence rates were extracted from the existing literature, giving emphasis to recent systematic reviews and RCTs. Results: Through 30 months of follow-up, the average cost of removing a LSCP cold EMR was $5,213, as compared to $6,168 by hot EMR, yielding a $955 USD cost difference (95% Confidence Interval (CI) $903-$1,006). Average days of lost productivity were 6.2 days for cold EMR and 6.3 days for hot EMR. This cost advantage remained over several analyses accounting for variations in recurrence rates and clip closure strategies. Clip cost and LSCP recurrence rate had the greatest, and least impact on marginal cost difference, respectively. Conclusion: Cold EMR is the dominant strategy over hot EMR, with less cost and better quality of life. In theory, a complete transition to cold EMR for LSCPs in the US could result in an annual cost-savings approaching $7 million US dollars to Medicare beneficiaries.


2004 ◽  
Vol 19 (12) ◽  
pp. 1397-1402 ◽  
Author(s):  
DIMITRIOS XINOPOULOS ◽  
DIMITRIOS DIMITROULOPOULOS ◽  
IOANNA MOSCHANDREA ◽  
PANAGIOTIS SKORDILIS ◽  
ATHANASSIOS BAZINIS ◽  
...  

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