기사
Spinal cord stimulation for failed back surgery syndrome: A decision-analytic model and cost-effectiveness analysis /
- 개인저자
- Taylor, Rebecca J. ;, Taylor, Rod S.
- 수록페이지
- 351-358 p.
- 발행일자
- 2005.08.29
- 출판사
- Cambridge University Press
초록
[영문]Objectives: The aim of this study was to develop a decision-analytic model to assess the cost-effectiveness of spinal cord stimulation (SCS), relative to nonsurgical conventional medical management (CMM), for patients with failed back surgery syndrome (FBSS).Methods: A decision tree and Markov model were developed to synthesize evidence on both health-care costs and outcomes for patients with FBSS. Outcome data of SCS and CMM were sourced from 2-year follow-up data of two randomized controlled trials (RCTs). Treatment effects were measured as levels of pain relief. Short- and long-term health-care costs were obtained from a detailed Canadian costing study in FBSS patients. Results are presented as incremental cost per quality adjusted life year (QALY) and expressed in 2003 Euros. Costs were discounted at 6 percent and outcomes at 1.5 percent.Results: Over the lifetime of the patient, SCS was dominant (i.e., SCS is cost-saving and gives more health gain relative to CMM); a finding that was robust across sensitivity analyses. At a 2-year time horizon, SCS gave more health gain but at an increased cost relative to CMM. Given the uncertainty in effectiveness and cost parameters, the 2-year cost-effectiveness of SCS ranged from €30,370 in the base case to €63,511 in the worst-case scenario.Conclusions: SCS was found to be both more effective and less costly than CMM, over the lifetime of a patient. In the short-term, although SCS is potentially cost-effective, the model results are highly sensitive to the choice of input parameters. Further empirical data are required to improve the precision in the estimation of short-term cost-effectiveness.
- 권/호
- v.21 no.3 2005 Summer
- 발행일
- 2005.08.29
- 구독상태
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Health needs assessment tools: Progress and potential / | Asadi-Lari, Mohsen ;, Gray, David | 288-297 | |
Self-reports of health-care utilization: Diary or questionnaire? / | Brink, Mandy van den. et al | 298-304 | |
Populating decision-analytic models: The feasibility and efficiency of database searching for individual parameters / | Golder, Su ;, Glanville, Julie ;, Ginnelly, Laurae ; | 305-311 | |
Toward a procedure for integrating moral issues in health technology assessment / | Hofmann, Bjørn | 312-318 |
- Association between methodological characteristics and outcome in health technology assessments which included case series /
- Health needs assessment tools: Progress and potential /
- Self-reports of health-care utilization: Diary or questionnaire? /
- Populating decision-analytic models: The feasibility and efficiency of database searching for individual parameters /
- Toward a procedure for integrating moral issues in health technology assessment /
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