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Cost and effectiveness of video-assisted thoracoscopic surgery for clinical stage I non-small cell lung cancer: a population-based analysis.

Authors :
Fang HY
Hsiao FY
Huang HC
Lin YS
Chen CY
Shieh SH
Chen PR
Chen CK
Chien CR
Source :
Journal of thoracic disease [J Thorac Dis] 2014 Dec; Vol. 6 (12), pp. 1690-6.
Publication Year :
2014

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to conventional surgery (CS). We aimed to estimate the short-term cost-effectiveness of VATS vs. CS for clinical stage I non-small cell lung cancer (NSCLC-c-stage-I) patients from the payer's perspective (National Health Insurance).<br />Methods: We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007-2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was 1 year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment.<br />Results: Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4 [7] and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively.<br />Conclusions: We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (1 year) within the common WTP levels in Taiwan.

Details

Language :
English
ISSN :
2072-1439
Volume :
6
Issue :
12
Database :
MEDLINE
Journal :
Journal of thoracic disease
Publication Type :
Academic Journal
Accession number :
25589961
Full Text :
https://doi.org/10.3978/j.issn.2072-1439.2014.10.27