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 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.

• 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