Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia
Introduction: Although there are several treatments for carpal tunnel syndrome (CTS), the efficiency of these has not evaluated in Colombia. Objective: Determine the incremental cost-utility ratio (ICUR) of medical and surgical treatment in patients with CTS. Material and methods: A cost utility ana...
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| Format: | Article |
| Language: | Spanish |
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Universidad Colegio Mayor Nuestra Señora del Rosario
2015-05-01
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| Series: | Revista Ciencias de la Salud |
| Subjects: | |
| Online Access: | http://revistas.urosario.edu.co/index.php/revsalud/article/view/3805 |
| _version_ | 1818918224524214272 |
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| author | César Augusto Guevara Yuri Takeuchi |
| author_facet | César Augusto Guevara Yuri Takeuchi |
| author_sort | César Augusto Guevara |
| collection | DOAJ |
| description | Introduction: Although there are several treatments for carpal tunnel syndrome (CTS), the efficiency of these has not evaluated in Colombia. Objective: Determine the incremental cost-utility ratio (ICUR) of medical and surgical treatment in patients with CTS. Material and methods: A cost utility analysis was conducted from the societal perspective with patients older than 18 years
diagnosed with CTS who received medical or surgical treatment. Quality-adjusted life-years (QALYs) were calculated using the EQ-5D. Costs were obtained from the ISS national tariff 2001+30 %. The results were extrapolated to long term through a Markov model with a discount rate of 3,5 %. A probabilistic sensitivity analysis using Monte Carlo simulation was performed.
Results: Fifty- three patients participated, women (71,7 %); mean age: 55,5 years. 79 % of patients received medical treatment. The most frequent treatment was medical observation (66,7 %) and NSAIDs (16,6 %). Medical treatment provided 0,33 QALYs (± 0,11) and surgery 0,37 (± 0,10).
The average total cost of medical treatment at 6 months and 20 years was COP 132 006 (95 % CI: COP 70 255 - 425 341) and COP 483 440 (95 % CI: COP 104 310 - 862 570) respectively. The cost of surgery was COP 1 972 644 (95 % CI: COP 981 204 - 8 517 065) and COP 979 585 (95 %: COP 684 912 - 1 274 258). The surgery was dominated by 6 months. The ICUR at 20 years was COP 1 033 635/QALY additional (95 % CI: COP 840 179 - 1 235 323/additional QALY) with a 80 % of probability that surgery be cost-utility when there is a willingness to pay COP 5 000 000. Conclusion: The medical treatment is cost-effective with regard to the surgery in short term. However, in the long term the surgery is cost effective with respect to the medical treatment. |
| first_indexed | 2024-12-20T00:46:34Z |
| format | Article |
| id | doaj.art-a559870fd605491f8dc7e622ccf810ce |
| institution | Directory Open Access Journal |
| issn | 1692-7273 1692-7273 |
| language | Spanish |
| last_indexed | 2024-12-20T00:46:34Z |
| publishDate | 2015-05-01 |
| publisher | Universidad Colegio Mayor Nuestra Señora del Rosario |
| record_format | Article |
| series | Revista Ciencias de la Salud |
| spelling | doaj.art-a559870fd605491f8dc7e622ccf810ce2022-12-21T19:59:23ZspaUniversidad Colegio Mayor Nuestra Señora del RosarioRevista Ciencias de la Salud1692-72731692-72732015-05-0113212514010.12804/revsalud13.02.2015.01Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, ColombiaCésar Augusto GuevaraYuri TakeuchiIntroduction: Although there are several treatments for carpal tunnel syndrome (CTS), the efficiency of these has not evaluated in Colombia. Objective: Determine the incremental cost-utility ratio (ICUR) of medical and surgical treatment in patients with CTS. Material and methods: A cost utility analysis was conducted from the societal perspective with patients older than 18 years diagnosed with CTS who received medical or surgical treatment. Quality-adjusted life-years (QALYs) were calculated using the EQ-5D. Costs were obtained from the ISS national tariff 2001+30 %. The results were extrapolated to long term through a Markov model with a discount rate of 3,5 %. A probabilistic sensitivity analysis using Monte Carlo simulation was performed. Results: Fifty- three patients participated, women (71,7 %); mean age: 55,5 years. 79 % of patients received medical treatment. The most frequent treatment was medical observation (66,7 %) and NSAIDs (16,6 %). Medical treatment provided 0,33 QALYs (± 0,11) and surgery 0,37 (± 0,10). The average total cost of medical treatment at 6 months and 20 years was COP 132 006 (95 % CI: COP 70 255 - 425 341) and COP 483 440 (95 % CI: COP 104 310 - 862 570) respectively. The cost of surgery was COP 1 972 644 (95 % CI: COP 981 204 - 8 517 065) and COP 979 585 (95 %: COP 684 912 - 1 274 258). The surgery was dominated by 6 months. The ICUR at 20 years was COP 1 033 635/QALY additional (95 % CI: COP 840 179 - 1 235 323/additional QALY) with a 80 % of probability that surgery be cost-utility when there is a willingness to pay COP 5 000 000. Conclusion: The medical treatment is cost-effective with regard to the surgery in short term. However, in the long term the surgery is cost effective with respect to the medical treatment.http://revistas.urosario.edu.co/index.php/revsalud/article/view/3805Carpal tunnel syndromecosts and costs analysiscost-benefit analysisquality of life |
| spellingShingle | César Augusto Guevara Yuri Takeuchi Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia Revista Ciencias de la Salud Carpal tunnel syndrome costs and costs analysis cost-benefit analysis quality of life |
| title | Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia |
| title_full | Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia |
| title_fullStr | Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia |
| title_full_unstemmed | Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia |
| title_short | Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia |
| title_sort | cost utility of interventions in patients with carpal tunnel syndrome in a universitary hospital in cali colombia |
| topic | Carpal tunnel syndrome costs and costs analysis cost-benefit analysis quality of life |
| url | http://revistas.urosario.edu.co/index.php/revsalud/article/view/3805 |
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