Economic evaluation of a steroid-eluting sinus implant following endoscopic sinus surgery for chronic rhinosinusitis

Luke Rudmik, Timothy Smith

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 nonsteroideluting sinus implant strategies were $1,572.91 and $365.18, respectively. The steroid-eluting strategy incremental costeffectiveness ratio was $5,489.68. The sensitivity analysis demonstrated a 74.3%, 87.2%, and 90.5% certainty that the steroideluting 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.

Original languageEnglish (US)
Pages (from-to)359-366
Number of pages8
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume151
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Mometasone Furoate
Cost-Benefit Analysis
Steroids
Costs and Cost Analysis
Pharmaceutical Databases
Health Insurance Reimbursement
Decision Trees
Medicaid
Otolaryngology
Medicare
Ambulatory Surgical Procedures
Meta-Analysis
Economics
Delivery of Health Care

Keywords

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

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

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title = "Economic evaluation of a steroid-eluting sinus implant following endoscopic sinus surgery for chronic rhinosinusitis",
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 nonsteroideluting sinus implant strategies were $1,572.91 and $365.18, respectively. The steroid-eluting strategy incremental costeffectiveness ratio was $5,489.68. The sensitivity analysis demonstrated a 74.3{\%}, 87.2{\%}, and 90.5{\%} certainty that the steroideluting 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.",
keywords = "chronic rhinosinusitis, cost-effectiveness, economic evaluation, endoscopic sinus surgery, implant, Propel, sinusitis, spacer, stent, topical corticosteroid",
author = "Luke Rudmik and Timothy Smith",
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pages = "359--366",
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N2 - 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 nonsteroideluting sinus implant strategies were $1,572.91 and $365.18, respectively. The steroid-eluting strategy incremental costeffectiveness ratio was $5,489.68. The sensitivity analysis demonstrated a 74.3%, 87.2%, and 90.5% certainty that the steroideluting 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.

AB - 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 nonsteroideluting sinus implant strategies were $1,572.91 and $365.18, respectively. The steroid-eluting strategy incremental costeffectiveness ratio was $5,489.68. The sensitivity analysis demonstrated a 74.3%, 87.2%, and 90.5% certainty that the steroideluting 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.

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KW - cost-effectiveness

KW - economic evaluation

KW - endoscopic sinus surgery

KW - implant

KW - Propel

KW - sinusitis

KW - spacer

KW - stent

KW - topical corticosteroid

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