Cost-Effectiveness Analysis of Gallstone Lithotripsy

摘要

The objective of the research was to estimate the cost-effectiveness of extracorporeal shock wave lithotripsy (ESWL) versus surgery for treatment of gallstones. The researchers estimated expected costs for treatment by ESWL or surgery, estimated patient and physician utility values associated with treatment outcomes, and incorporated these estimates into a computerized simulation model. The findings suggest that expected survival is likely to be longer with ESWL than surgery, but only for patients that have a single stone or for elderly patients with multiple stones. Total long-term charges associated with ESWL generally will exceed those of surgery and often have a relatively high (or poor) marginal cost-effectiveness ratio of extra charges per quality-adjusted year of life gained. ESWL is projected to be less cost-effective in women than in men and less cost-effective for multiple stones than for a single stone.