Postpartum Opportunistic Salpingectomy Compared With Bilateral Tubal Ligation After Vaginal Delivery for Ovarian Cancer Risk Reduction: A Cost-Effectiveness Analysis.
| Autor: | Wagar MK; Division of Gynecologic Oncology and the Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; the Department of Health Care Financing & Payment, Research Triangle Institute, Research Triangle Park, North Carolina; the Department of Accounting, Finance and Economics, Winthrop University, Rock Hill, South Carolina; and the Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri., Forlines GL, Moellman N, Carlson A, Matthews M, Williams M |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Obstetrics and gynecology [Obstet Gynecol] 2023 Apr 01; Vol. 141 (4), pp. 819-827. Date of Electronic Publication: 2023 Mar 09. |
| DOI: | 10.1097/AOG.0000000000005118 |
| Abstrakt: | Objective: To compare the cost effectiveness of opportunistic salpingectomy and bilateral tubal ligation for sterilization immediately after vaginal delivery. Methods: A cost-effectiveness analytic decision model was used to compare opportunistic salpingectomy with bilateral tubal ligation during vaginal delivery admission. Probability and cost inputs were derived from local data and available literature. Salpingectomy was assumed to be performed with a handheld bipolar energy device. The primary outcome was the incremental cost-effectiveness ratio (ICER) in 2019 U.S. dollars per quality-adjusted life-year (QALY) at a cost-effectiveness threshold of $100,000/QALY. Sensitivity analyses were performed to determine the proportion of simulations in which salpingectomy would be cost effective. Results: Opportunistic salpingectomy was more cost effective than bilateral tubal ligation with an ICER of $26,150/QALY. In 10,000 patients desiring sterilization after vaginal delivery, opportunistic salpingectomy would result in 25 fewer ovarian cancer cases, 19 fewer ovarian cancer deaths, and 116 fewer unintended pregnancies than bilateral tubal ligation. In sensitivity analysis, salpingectomy was cost effective in 89.8% of simulations and cost saving in 13% of simulations. Conclusion: In patients undergoing sterilization immediately after vaginal deliveries, opportunistic salpingectomy is more cost effective and may be more cost saving than bilateral tubal ligation for reducing ovarian cancer risk. Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest. (Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|