The cost-effectiveness of open or thoracoscopic thymectomy compared to medical treatment in managing myasthenia gravis without thymomas

Objective Assessing the cost-effectiveness of open or thoracoscopic thymectomycompared to medical therapy in managing myasthenia gravis not associated with thymoma.Methods A Markov model was designed for evaluating three strategies’ costeffectiveness.Transition probabilities were taken from the pert...

Full description

Autores:
Chicaiza Becerra, Liliana Alejandra
García-Molina, Mario
Gamboa, Oscar
Castañeda, Carlos
Tipo de recurso:
Article of journal
Fecha de publicación:
2012
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/33719
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/33719
http://bdigital.unal.edu.co/23799/
http://bdigital.unal.edu.co/23799/2/
http://bdigital.unal.edu.co/23799/4/1675
Palabra clave:
Medicina
economía
economía de la salud
Myasthenia gravis
therapeutics
thymectomy
cost-benefit analysis
Colombia.
Rights
openAccess
License
Atribución-NoComercial 4.0 Internacional
Description
Summary:Objective Assessing the cost-effectiveness of open or thoracoscopic thymectomycompared to medical therapy in managing myasthenia gravis not associated with thymoma.Methods A Markov model was designed for evaluating three strategies’ costeffectiveness.Transition probabilities were taken from the pertinent literature; the costs were estimated from official tariff manuals. Incremental cost-effectiveness ratios were estimated and probabilistic and deterministic sensitivity analysis was used for clinical variables, costs and the model´s assumptions.Results Thoracoscopic thymectomy was the most effective and least costly strategy and dominated the other two alternatives. The cost per life year gained was Col $ 1 129 531 without discount and Col $ 805 179 with discount. Univariate sensitivity analysis showed that the main variables affecting the results were the effects’ discount rate, the cost of a myasthenic crisis and the probability of complete remission. Thoracoscopy thymectomy was the most cost-effective strategy for different thresholds of willingness to pay in probabilistic analysis.Conclusions Thoracoscopic thymectomy is a cost-effective strategy in the treatment of MG without thymoma.