科研之友
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摘要
Objective %26lt;br%26gt;To determine if the cost of administering alvimopan, to help restore bowel function after abdominal surgery, to all patients undergoing radical cystectomy (RC) is cost prohibitive. %26lt;br%26gt;Patients and Methods %26lt;br%26gt;A cost-effective analysis was conducted from a healthcare payer perspective using a decision-tree model that incorporated direct healthcare costs and probabilities associated with the possible events and outcomes. %26lt;br%26gt;Sensitivity analyses were conducted on the influence of the cost and effectiveness of the drug, the probability of POI in RC patients, and the extended length of stay (LOS) as a result of POI. Precision in estimates was determined using probabilistic sensitivity analyses with 5000 Monte-Carlo simulations. %26lt;br%26gt;Results %26lt;br%26gt;Under the base case assumption, the additional cost of a patient%26apos;s LOS related to POI was $ 10 246 per person. Under the assumption that 15.6% of patients will have POI, the mean cost associated with POI in a cohort of patients not treated with alvimopan was $ 1597 (90% confidence interval [CI] $ 1335-1875) per patient. Conversely, the routine use of alvimopan for all patients undergoing RC was associated with a mean POI-associated cost of $ 1495(90% CI $ 1312-1696) per person, which represents the cost of alvimopan ($ 700 per hospitalisation) and a 50% reduction in the rate of POI. Sensitivity analyses revealed that there is a cost savings with the routine use of alvimopan under the following conditions: the POI results in extending LOS by 3.5 days, POI occurs in 14% of patients undergoing RC, or the drug results in a relative risk reduction of 44%. %26lt;br%26gt;Conclusions %26lt;br%26gt;Routine use of perioperative alvimopan may not be cost prohibitive because of its influence on POI rate and associated costs. The cost-effectiveness of alvimopan is influenced by the POI incidence and the degree to which the drug can decrease the LOS.
- 出版日期2013-6
