Prevention of adhesion formation after radical hysterectomy using a sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier: A cost-effectiveness analysis

Robert E. Bristow, Antonio Santillan, Teresa P. Diaz-Montes, Ginger J. Gardner, Robert L. Giuntoli, Susan T. Peeler

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the cost-effectiveness of an adhesion prevention strategy compared to routine care, in which no adhesion prevention measures are taken, through a decision analysis model in the clinical setting of patients undergoing radical hysterectomy and pelvic lymphadenectomy for Stage IB cervical cancer. Methods: A decision analysis model compared two strategies to manage the risk of adhesion-related morbidity following radical hysterectomy for Stage IB cervical cancer: (1) routine care with no adhesion prevention measures, and (2) the intervention strategy with a HA-CMC anti-adhesion barrier. The cost-effectiveness of each strategy was evaluated from the perspective of society and that of a third party payer. Results: From the perspective of society, the HA-CMC strategy had an overall cost per patient of $1932 and effectiveness of 7.901 QALYs and dominated the routine care strategy, which had a cost per patient of $3043 and effectiveness of 7.805 QALYs. From the perspective of a third party payer, the HA-CMC strategy had an overall cost per patient of $1247 and effectiveness of 7.987 QALYs and dominated the routine care strategy, which had a cost per patient of $1629 and effectiveness of 7.970 QALYs. A series of one-way sensitivity analyses confirmed the robustness of the model. Conclusions: Under a conservative set of clinical and economic assumptions, an adhesion prevention strategy utilizing a HA-CMC barrier in patients undergoing radical hysterectomy for Stage IB cervical cancer is cost-effective from both the perspective of society as a whole and that of a third party payer.

Original languageEnglish (US)
Pages (from-to)739-746
Number of pages8
JournalGynecologic oncology
Volume104
Issue number3
DOIs
StatePublished - Mar 1 2007

Keywords

  • Adhesion prevention
  • Cost-effectiveness
  • Radical hysterectomy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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