UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Cost-Utility Analysis of Surgery and Radiotherapy for Symptomatic Spinal Metastases in a Belgian Specialist Center

Depreitere, B; Turner, I; Vandoren, C; Choi, D; (2019) Cost-Utility Analysis of Surgery and Radiotherapy for Symptomatic Spinal Metastases in a Belgian Specialist Center. World Neurosurgery , 125 e537-e543. 10.1016/j.wneu.2019.01.130. Green open access

[img]
Preview
Text
1-s2.0-S187887501930230X-main.pdf - Accepted version

Download (1MB) | Preview

Abstract

Objective: Spinal metastases represent the most common site of bony metastases and frequently reduce quality of life. A beneficial effect of surgery and radiotherapy versus radiotherapy alone has been demonstrated in symptomatic patients. The goal of our study was to perform a cost-utility analysis of surgery for spinal metastases based on patient-level costs and health status data in a specialist spine center in Belgium. / Methods: A cost-utility analysis was performed in a prospective cohort of patients undergoing surgery for symptomatic spinal metastases in 2011–2015. EQ-5D-3L measure of health-related quality of life data were collected preoperatively and at 3, 6, 12, and 24 months. Hospital costs relating to surgical management including postoperative radiotherapy were analyzed. A retrospective cohort of patients treated with radiotherapy alone between 2011 and 2015, which matched the surgical patients for disease load and presentation, also was assessed. Quality-adjusted life years (QALYs) for nonsurgical patients were modelled against the surgical group. / Results: In total, 38 consecutive surgical patients had information for cost-utility analysis and 8 nonsurgical patients were matched. Mean total cost in the surgical group was €16,989 (SD €8148), largely comprising nonmedical staffing cost (mean €7721, 45.9%), followed by daily operational costs (€2963, 17.6%) and medical staffing costs (€2621, 15.6%). Median initial health status was 0.33 (interquartile range 0.15–0.55), and median postoperative QALYs were 0.70 (interquartile range 0.18–1.70). Mean total cost in the nonsurgical cohort was €9354. The incremental cost-effectiveness ratio for surgical management was €13,635 (range €12,726–€14,407) per QALY. / Conclusions: Surgery for symptomatic spinal metastases in a specialist hospital in Belgium is cost-effective.

Type: Article
Title: Cost-Utility Analysis of Surgery and Radiotherapy for Symptomatic Spinal Metastases in a Belgian Specialist Center
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.wneu.2019.01.130
Publisher version: https://doi.org/10.1016/j.wneu.2019.01.130
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Cost, Cost-utility, ICER, QALY, metastasis, spine, surgery
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10068581
Downloads since deposit
20Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item