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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 2/2014

01-04-2014 | Original Research Article

Cost-Utility Analysis Comparing Heavy-Weight and Light-Weight Mesh in Laparoscopic Surgery for Unilateral Inguinal Hernias

Authors: Dmitrij Achelrod, Tom Stargardt

Published in: Applied Health Economics and Health Policy | Issue 2/2014

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Abstract

Background

Hernioplasty is one of the most frequent surgeries in the UK. Light-weight mesh (LWM) has the potential to reduce chronic groin pain but its cost-effectiveness compared with heavy-weight mesh (HWM) is unknown.

Objective

Our objective was to conduct a cost-utility analysis between laparoscopic hernioplasty with HWM and LWM for unilateral inguinal hernias.

Methods

A Markov model simulated costs and health outcomes over a period of 1 year (2012) from the societal and National Health Service (NHS) perspective (England). The main outcome was cost per quality-adjusted life-year (QALY) gained. Surgery results were gleaned from the randomized control trial by Bittner et al. Other input parameters were drawn from the literature and public sources of the NHS.

Results

From the societal perspective, LWM induces lower incremental costs (−£88.85) than HWM but yields a slightly smaller incremental effect (−0.00094 QALYs). The deterministic incremental cost-effectiveness ratio (ICER) for HWM compared with LWM amounts to £94,899 per QALY, while the probabilistic ICER is £118,750 (95 % confidence interval [CI] £57,603–180,920). Owing to the withdrawal of productivity losses from the NHS perspective, LWM causes higher incremental costs (£13.09) and an inferior incremental effect (−0.00093), resulting in a dominance of HWM over LWM (ICER 95 % CI −£12,382 to −£21,590).

Conclusions

There is no support for the adoption of LWM as standard treatment from an NHS perspective. However, given the small differences between HWM and LWM, LWM has at least the potential of improving patient outcomes and reducing expenditure from the societal perspective.
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Metadata
Title
Cost-Utility Analysis Comparing Heavy-Weight and Light-Weight Mesh in Laparoscopic Surgery for Unilateral Inguinal Hernias
Authors
Dmitrij Achelrod
Tom Stargardt
Publication date
01-04-2014
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 2/2014
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-014-0082-0

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