Pakkapol Sukhvibul MD¹, Suphakarn Techapongsatorn MD, PhD¹, Kamolpat Chaiyakittisopon PharmD², Boonying Siribumrungwong MD, PhD³, Amarit Tansawet MD¹
Affiliation : ¹ Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand ² Department of Community Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand ³ Department of Surgery, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
Objective: To evaluate cost-effectiveness of ring wound protector (RWP) used in open appendectomy.
Materials and Methods: The present study was a decision-tree-based analysis. Model inputs, including costs, utilities, and probabilities of surgical site infection (SSI), were retrieved from the previous studies. The incremental cost-effectiveness ratio (ICER) represented the cost of one additional quality-adjusted life day (QALD). This ratio was calculated by dividing the incremental cost [Thai Baht (THB)] by the incremental QALD. One-way sensitivity analyses were performed by varying each input parameter to see how ICER change. Monte-Carlo simulation with 5,000 replications was used to estimate probabilistic ICER and construct the acceptability curve, demonstrating how the probability of being cost-effective changed when the willingness-to-pay (WTP) threshold was shifted.
Results: The deterministic ICER of 64,630.78 THB/QALD did not favor RWP use compared with the WTP threshold of 10,000 THB/QALD. However, if the threshold was shifted to 100,000 THB/QALD, it would yield approximately 75% probability of being cost-effective from RWP. Threshold analysis indicated that RWP should cost 281, 301, and 661 THB to be cost-effective at the threshold of 500, 1,000, and 10,000 THB/QALD, respectively.
Conclusion: Routine RWP use might not be cost-effective when QALD is the outcome of interest. Based on the results from the present study, policy-makers could be informed that the adoption of this health technology might not be suitable.
Received 2 August 2021 | Revised 3 November 2021 | Accepted 3 November 2021
doi.org/10.35755/jmedassocthai.2021.12.13195
Keywords : Ring wound protector; Appendectomy; Cost-utility analysis; Decision tree model
JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND
4th Floor, Royal Golden Jubilee Building,
2 Soi Soonvijai, New Petchburi road,
Bangkok 10310, Thailand.
Phone: 0-2716-6102, 0-2716-6962
Fax: 0-2314-6305
Email: editor@jmatonline.com
» Online Submissions » Author Guidelines » Copyright Notice » Privacy Statement
» Journal Sponsorship » Site Map » About this Publishing System
© MEDICAL ASSOCIATION OF THAILAND. All Rights Reserved. The content of this site is intended for health professionals.