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Cost‐effectiveness of endoscopic endonasal vs transcranial approaches for olfactory groove meningioma
Author(s) -
Fu Terence S.,
Yao Christopher M. K. L.,
Ziai Hedyeh,
Monteiro Eric,
Almeida Joao Paulo,
Zadeh Gelareh,
Gentili Fred,
Almeida John R.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26462
Subject(s) - medicine , willingness to pay , surgery , economics , microeconomics
Background Endoscopic endonasal approaches (EEAs) have been adopted as an alternative to standard transcranial approaches for olfactory groove meningiomas (OGMs). However, the relative cost‐effectiveness remains controversial. Methods Cost‐utility analysis from a societal perspective comparing EEA vs transcranial approaches for OGM was used in this study. Surgical treatment was modeled using decision analysis, and a Markov model was adopted over a 20‐year horizon. Parameters were obtained from literature review. Costs were expressed in 2017 Canadian dollars. Results In the base case, EEA was cost‐effective compared with transcranial surgery with an incremental cost‐effectiveness ratio of $33 523 ($30 475 USD)/QALY. There was a 55% likelihood that EEA was cost‐effective at a willingness‐to‐pay of $50 000/QALY. EEA remained cost‐effective at a cerebrospinal fluid leak rate below 60%, gross total resection rate above 25%, and base cost less than $66 174 ($60 158 USD). Conclusion EEA may be a cost‐effective alternative to transcranial approaches for selected OGM.