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Otolaryngol Head Neck Surg. 2014 May 5;151(2):359-366. [Epub ahead of print]

Economic Evaluation of a Steroid-Eluting Sinus Implant following Endoscopic Sinus Surgery for Chronic Rhinosinusitis.

Author information

  • 1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada lukerudmik@gmail.com.
  • 2Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.

Abstract

OBJECTIVE:

This study aimed to evaluate the cost-effectiveness of a mometasone steroid-eluting sinus implant compared to a nonsteroid-eluting sinus implant following endoscopic sinus surgery (ESS) for chronic rhinosinusitis.

STUDY DESIGN:

Economic evaluation using a decision tree model.

SETTING:

Academic and nonacademic otolaryngology practices.

SUBJECTS:

Patients with refractory chronic rhinosinusitis undergoing ESS.

METHODS:

The economic perspective was the health care third party payer. Effectiveness and probability data were obtained from a single meta-analysis of 2 randomized, double-blind, controlled trials. Costs were obtained from the Centers for Medicare & Medicaid Services database and wholesale pharmaceutical pricing. Multiple sensitivity analyses were performed including a probabilistic sensitivity analysis. Comparative treatment groups were (1) placement of the mometasone steroid-eluting sinus implant following ESS and (2) placement of a nonsteroid-eluting implant following ESS. The primary outcome was cost per postoperative intervention avoided within 60 days after ESS.

RESULTS:

The mean cost for the steroid-eluting and nonsteroid-eluting sinus implant strategies were $1,572.91 and $365.18, respectively. The steroid-eluting strategy incremental cost-effectiveness ratio was $5,489.68. The sensitivity analysis demonstrated a 74.3%, 87.2%, and 90.5% certainty that the steroid-eluting implant strategy is cost-effective at willingness-to-pay thresholds of $10,000, $25,000, and $50,000, respectively.

CONCLUSION:

Results from this economic evaluation suggest that placement of a mometasone steroid-eluting sinus implant into the ethmoid cavity following ESS for refractory chronic rhinosinusitis is a cost-effective intervention for preventing a postoperative intervention within 60 days after surgery.

© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

KEYWORDS:

Propel; chronic rhinosinusitis; cost-effectiveness; economic evaluation; endoscopic sinus surgery; implant; sinusitis; spacer; stent; topical corticosteroid

PMID:
24796330
[PubMed - as supplied by publisher]
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