Cost-effectiveness of anterotemporal lobectomy in medically intractable complex partial epilepsy.
The value of high-cost health technologies is being increasingly scrutinized by providers of health care.
An understanding of the costs and outcomes of hightechnology epilepsy care is required to ensure efficient resource allocation.
Decision analysis was used to estimate the cost effectiveness of anterotemporal lobectomy (ATL) as compared with standard medical management in medically-intractable epilepsy.
Local (Rochester, NY, U.S.A.) cost data were applied to a model of lifetime discounted costs and outcomes of evaluation, ATL, and follow-up in a hypothetical cohort of patients.
Base case analysis yielded a marginal cost-effectiveness ratio (MECR) of $15,581/quality-adjusted life year (QALY).
Extensive sensitivity analyses identified extreme conditions in which evaluation for ATL was dominant (more effective and less costly) or in which it might be considered not worth the cost (MCER>$50,000/QALY).
Estimates of ATL cost effectiveness fall within a generally acceptable range, even when uncertainty about many model parameters is taken into account.
Under assumptions based on available data in the literature, the cost effectiveness of ATL compares favorably with that of other health technologies. (...)
Mots-clés Pascal : Epilepsie partielle complexe, Lobectomie, Lobe temporal, Résistance traitement, Analyse coût efficacité, Traitement, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Chirurgie
Mots-clés Pascal anglais : Complex partial epilepsy, Lobectomy, Temporal lobe, Negative therapeutic reaction, Cost efficiency analysis, Treatment, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0192318
Code Inist : 002B17A03. Création : 21/05/1997.