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...
- 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
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. |
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