Cost-Effectiveness Analysis of Robotic-assisted Lobectomy for Non-Small Cell Lung Cancer
| Autor: | Brendan T. Heiden, Bryan F. Meyers, Varun Puri, Su-Hsin Chang, Joshua D. Mitchell, Benjamin D. Kozower, Eric Rome |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty animal structures Lung Neoplasms Robotic assisted Cost-Benefit Analysis VATS lobectomy Resection Quality of life Robotic Surgical Procedures Carcinoma Non-Small-Cell Lung medicine Humans Lung cancer Pneumonectomy health care economics and organizations Retrospective Studies business.industry Thoracic Surgery Video-Assisted Cost-effectiveness analysis medicine.disease Surgery Treatment Outcome Thoracotomy Cardiothoracic surgery Quality of Life Non small cell Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 114(1) |
| ISSN: | 1552-6259 |
| Popis: | Robot-assisted thoracic surgery has emerged as an alternative to video-assisted thoracic surgery (VATS) for treating patients with resectable non-small cell lung cancer. The objective of this study was to evaluate the cost effectiveness of robotic-assisted lobectomy (RAL) compared with VATS and open lobectomy for adults with NSCLC.A decision analysis model was employed to compare the cost effectiveness of RAL, VATS, and open lobectomy with 1-year time horizon from both health care and societal perspectives. Health care costs (2020$) and quality-adjusted life-years were compared between the approaches. The incremental cost-effectiveness ratio was calculated in terms of cost per quality-adjusted life-years gained. Sensitivity analyses were performed to identify variables driving cost effectiveness across several willingness-to-pay thresholds.Open thoracotomy was not cost effective compared with both RAL and VATS lobectomy. From the health care sector perspective, RAL was $394.97 more expensive per case than VATS resulting in an incremental cost-effectiveness ratio of $180 755.10 per quality-adjusted life-year. From the societal perspective, RAL was $247.77 more expensive per case than VATS, resulting in an incremental cost-effectiveness ratio of $113 388.80 per quality-adjusted life-years. Robotic-assisted lobectomy becomes cost effective with marginally lower robotic instrument costs, shorter operating room times, lower conversion rates, shorter lengths of stay, higher hospital volumes, and improved quality of life. Robotic-assisted lobectomy is also cost effective if surgeons can increase the proportion of minimally invasive lobectomies using robotic technology.Compared with VATS, RAL is not cost effective for lung cancer lobectomy at lower willingness-to-pay thresholds. However, several factors may drive RAL to emerge as the more cost-effective approach for minimally invasive lung cancer resection. |
| Databáze: | OpenAIRE |
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