Cost-utility analysis of breast reduction surgery for women with symptomatic breast hypertrophy.

Autor: Crittenden TA; Flinders Medical Centre, Adelaide, SA.; Flinders University, Adelaide, SA., Ratcliffe J; Caring Futures Institute, Flinders University, Adelaide, SA., Watson DI; Flinders University, Adelaide, SA., Mpundu-Kaambwa C; Caring Futures Institute, Flinders University, Adelaide, SA., Dean NR; Flinders Medical Centre, Adelaide, SA.; Flinders University, Adelaide, SA.
Jazyk: angličtina
Zdroj: The Medical journal of Australia [Med J Aust] 2022 Feb 21; Vol. 216 (3), pp. 147-152. Date of Electronic Publication: 2021 Nov 16.
DOI: 10.5694/mja2.51343
Abstrakt: Objective: To assess the cost-effectiveness of breast reduction surgery for women with symptomatic breast hypertrophy in Australia.
Design: Cost-utility analysis of data from a prospective cohort study.
Setting, Participants: Adult women with symptomatic breast hypertrophy assessed for bilateral breast reduction at the Flinders Medical Centre, a public tertiary hospital in Adelaide, April 2007 - February 2018. The control group included women with breast hypertrophy who had not undergone surgery.
Main Outcome Measures: Health care costs (for the surgical admission and other related hospital costs within 12 months of surgery) and SF-6D utility scores (measure of health-related quality of life) were used to calculate incremental costs per quality-adjusted life-year (QALY) gained over 12 months, extrapolated to a 10-year time horizon.
Results: Of 251 women who underwent breast reduction, 209 completed the baseline and at least one post-operation assessment (83%; intervention group); 124 of 350 invited women waiting for breast reduction surgery completed the baseline and 12-month assessments (35%; control group). In the intervention group, the mean SF-6D utility score increased from 0.313 (SD, 0.263) at baseline to 0.626 (SD, 0.277) at 12 months; in the control group, it declined from 0.296 (SD, 0.267) to 0.270 (SD, 0.257). The mean QALY gain was consequently greater for the intervention group (adjusted difference, 1.519; 95% CI, 1.362-1.675). The mean hospital cost per patient was $11 857 (SD, $4322), and the incremental cost-effectiveness ratio (ICER) for the intervention was $7808 per QALY gained. The probability of breast reduction surgery being cost-effective was 100% at a willingness-to-pay threshold of $50 000 per QALY and 88% at $28 033 per QALY.
Conclusions: Breast reduction surgery for women with symptomatic breast hypertrophy is cost-effective and should be available to women through the Australian public healthcare system.
(© 2021 AMPCo Pty Ltd.)
Databáze: MEDLINE
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