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Cost‐Effectiveness of Surgery Versus Organ Preservation in Advanced Laryngeal Cancer
Author(s) -
Beck AnnJean C. C.,
Harten Wim H.,
Brekel Michiel W. M.,
Navran Arash,
Retèl Valesca P.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28954
Subject(s) - medicine , laryngectomy , incremental cost effectiveness ratio , quality of life (healthcare) , population , quality adjusted life year , cancer , health care , cost effectiveness , radiation therapy , health economics , adverse effect , larynx , surgery , intensive care medicine , environmental health , risk analysis (engineering) , public health , nursing , economics , economic growth
Objective Treatment decision‐making for patients with laryngeal cancer consists of a complex trade‐off between survival and quality of life. For decision makers on coverage and guidelines, costs come in addition to this equation. Our aim was to perform a cost‐effectiveness analysis of surgery (laryngectomy with or without radiotherapy) versus organ preservation (OP: radiotherapy, chemo‐ and/or bioradiation) in advanced laryngeal cancer patients from a healthcare perspective. Methods A cost‐effectiveness analysis was conducted using a Markov model. For each modality, data on survival and quality‐adjusted life years (QALYs) were sourced from relevant articles in agreement with experts, and national benchmark cost prices were included regarding treatment, follow‐up, adverse events, and rehabilitation. Results Total QALYs of the surgical approach (6.59) were substantially higher compared to the OP approach (5.44). Total lifetime costs were higher for the surgical approach compared to the OP approach, namely €95,881 versus €47,233. The surgical approach was therefore more effective and more costly compared to OP, resulting in an incremental cost‐effectiveness ratio of €42,383/QALY. Conclusion Based on current literature, surgical treatment was cost‐effective compared to OP in advanced laryngeal cancer within most willingness‐to‐pay thresholds. The study provides information on the survival adjusted for quality of life in combination with costs of two different approaches for advanced laryngeal cancer, relevant for patients, physicians, and policy makers. As financial toxicity is a relevant aspect in this population, collection of real‐world data on country‐specific costs and utilities is strongly recommended to enable further generalization. Level of Evidence N/A. Laryngoscope , 131:E509–E517, 2021