Economic Evaluation of Laparoscopic Cholecystectomy Versus Open Cholecystectomy

Authors

  • Attasit Srisubat Institute of Medical Research and Technology Assessment, Department of Medical Services
  • Arunee Thaiyakul Institute of Medical Research and Technology Assessment, Department of Medical Services
  • Suthaluk Kwanjaroensub Institute of Medical Research and Technology Assessment, Department of Medical Services
  • Nattaya Sa-nga Institute of Medical Research and Technology Assessment, Department of Medical Services
  • Surawut Paiprarert Nopparat Rajathanee Hospital
  • Ratchamon Pinyoteppratarn Rajavithi Hospital
  • Ongaraj Wijinthanasan Lerdsin Hospital
  • Taweechai Wisanuyothin Maharat Nakhon Ratchasima Hospital
  • Phaiwit Sriphatphiriyakul Surat Thani Hospital
  • Phichai Phongmanjit Chiangrai Prachanukroh Hospital
  • Chaloemphon Boonmee Thabo Crown Prince Hospital
  • Wibun Phanthabordeekorn Phahonphonphayuhasena Hospital
  • Annop Wisetchu Phahonphonphayuhasena Hospital
  • Wiriya Kulapapuk Kamphaeng Phet Hospital
  • Yot Teerawattananon Health Intervention and Technology Assessment

Keywords:

Economic evaluation, Gall stone, Laparoscopic cholecystectomy, Open cholecystectomy, Cost-effectiveness

Abstract

Background: Laparoscopic cholecystectomy is a popular surgical procedure and more effective than open cholecystectomy. However, laparoscopic surgery is more expensive than open surgery. Objective: To assess the cost-effectiveness of laparoscopic cholecystectomy compared with open cholecystectomy in patients with gallstones. Method: A decision tree model was used for the cost-utility analysis from healthcare provider and societal perspective. The cost data of cholecystectomy were collected from 9 hospitals. The utility and other variables of both surgeries were collected from literature review. Results: The average cost of open cholecystectomy in healthcare provider and society perspective were 11,185.42 THB and 19,340.50 THB respectively, which was lower than of laparoscopic cholecystectomy at 21,011.14 THB in healthcare provider perspective and 23,963.60 THB in societal perspective. The cost differences between laparoscopic cholecystectomy and open cholecystectomy was 9,825.72 THB in healthcare provider perspective and 4,623.10 THB in society perspective. Based on literature review, the quality adjusted life year (QALY) of laparoscopic surgery was 0.894 and open surgery was 0.800. The incremental cost-effectiveness ratio (ICER) was 104,528.94 THB per QALY in healthcare provider perspective and 49,181.91 THB per QALY in societal perspective. Conclusion: Laparoscopic cholecystectomy was cost-effective because ICER was lower than the identified cost-effectiveness thresholds in Thailand 160,000 THB per QALY according to societal perspective.

References

Kercher KW, Heniford BT, Matthews BD, Smith TI, Lincourt AE,Hayes DH, et al. Laparoscopic versus open nephrectomy in 210consecutive patients: outcomes, cost, and changes in practicepatterns. Surg Endosc. 2003; 17:1889-95

Topal B, Peeters G, Verbert A, Penninckx F. Outpatientlaparoscopic cholecystectomy: clinical pathway implementationis effcient and cost effective and increases hospital bed capacity.Surg Endosc. 2007; 21: 1142-6.

Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G; ClinicalOutcomes of Surgical Therapy (COST) Study Group. Short-termquality-of-life outcomes following laparoscopic-assistedcolectomy vs open colectomy for colon cancer: a randomizedtrial. JAMA. 2002; 287:321-8.

Teerawattananon Y, Tancharoensathien V, Sriratana S,Rattanachuake T, Tanprayoon T, ratanaprisaan C, et al.Assessing the Cost-utility of Laparoscopic versus Conventionalopen Cholecystectomy: An Evidence for Public Reimbursementin Thailand. Journal of Health Science 2005; 14: 464-74.

McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E,Vale L, Grant A. Laparoscopic surgery for inguinal hernia repair:systematic review of effectiveness and economic evaluation.Health Technol Assess. 2005; 9:1-203.

Murray A, Lourenco T, de Verteuil R, Hernandez R, Fraser C,McKinley A, et al. Clinical effectiveness and cost-effectivenessof laparoscopic surgery for colorectal cancer: systematic reviewsand economic evaluation. Health Technol Assess. 2006; 10:1-141.

Thai Health Technology Assessment Guideline. 2ed, 2013.

Zacks SL, Sandler RS, Rutledge R, Brown RS Jr. A populationbased cohort study comparing laparoscopic cholecystectomyand open cholecystectomy. Am J Gastroenterol. 2002; 97:334-40.

Kesteloot K, Penninckx F. The costs and effects of open versuslaparoscopic cholecystectomies. Health Econ. 1993; 2:303-12.

Bass EB, Pitt HA, Lillemoe KD. Cost-effectiveness of laparoscopiccholecystectomy versus open cholecystectomy. Am J Surg. 1993;165:466-71.

Lombardo S, Rosenberg JS, Kim J, Erdene S, Sergelen O,Nellermoe J, Finlayson SR, Price RR. Cost and outcomes of openversus laparoscopic cholecystectomy in Mongolia. J Surg Res.2018 Sep;229:186-191.

McKellar DP, Johnson RM, Dutro JA, Mellinger J, Bernie WA,Peoples JB. Cost-effectiveness of laparoscopic cholecystectomy.Surg Endosc. 1995; 9:158-62.

Sutherland JM, Mok J, Liu G, Karimuddin A, Crump T. A Cost-UtilityStudy of Laparoscopic Cholecystectomy for the Treatment ofSymptomatic Gallstones. J Gastrointest Surg. 2020; 24:1314-19.

Downloads

Published

27-03-2023

How to Cite

1.
Srisubat A, Thaiyakul A, Kwanjaroensub S, Sa-nga N, Paiprarert S, Pinyoteppratarn R, Wijinthanasan O, Wisanuyothin T, Sriphatphiriyakul P, Phongmanjit P, Boonmee C, Phanthabordeekorn W, Wisetchu A, Kulapapuk W, Teerawattananon Y. Economic Evaluation of Laparoscopic Cholecystectomy Versus Open Cholecystectomy. J DMS [Internet]. 2023 Mar. 27 [cited 2024 Nov. 22];48(1):93-103. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/251955

Issue

Section

Original Article