Economic Evaluation of Laparoscopic Cholecystectomy Versus Open Cholecystectomy
Keywords:
Economic evaluation, Gall stone, Laparoscopic cholecystectomy, Open cholecystectomy, Cost-effectivenessAbstract
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.
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