Endoscopic full-thickness resection and its treatment alternatives in difficult-to-treat lesions of the lower gastrointestinal tract: a cost-effectiveness analysis
Objective Endoscopic full-thickness resection (EFTR) has shown efficacy and safety in the colorectum. The aim of this analysis was to investigate whether EFTR is cost-effective in comparison with surgical and endoscopic treatment alternatives. - Design Real data from the study cohort of the prospect...
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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
August 18, 2020
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| In: |
BMJ open gastroenterology
Year: 2020, Volume: 7, Issue: 1, Pages: 1-7 |
| ISSN: | 2054-4774 |
| DOI: | 10.1136/bmjgast-2020-000449 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1136/bmjgast-2020-000449 Verlag, kostenfrei, Volltext: https://bmjopengastro.bmj.com/content/7/1/e000449 
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| Author Notes: | Armin Kuellmer, Juliane Behn, Torsten Beyna, Brigitte Schumacher, Alexander Meining, Helmut Messmann, Horst Neuhaus, David Albers, Michael Birk, Andreas Probst, Martin Faehndrich, Thomas Frieling, Martin Goetz, Robert Thimme, Karel Caca, Arthur Schmidt |
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| 245 | 1 | 0 | |a Endoscopic full-thickness resection and its treatment alternatives in difficult-to-treat lesions of the lower gastrointestinal tract |b a cost-effectiveness analysis |c Armin Kuellmer, Juliane Behn, Torsten Beyna, Brigitte Schumacher, Alexander Meining, Helmut Messmann, Horst Neuhaus, David Albers, Michael Birk, Andreas Probst, Martin Faehndrich, Thomas Frieling, Martin Goetz, Robert Thimme, Karel Caca, Arthur Schmidt |
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| 520 | |a Objective Endoscopic full-thickness resection (EFTR) has shown efficacy and safety in the colorectum. The aim of this analysis was to investigate whether EFTR is cost-effective in comparison with surgical and endoscopic treatment alternatives. - Design Real data from the study cohort of the prospective, single-arm WALL RESECT study were used. A simulated comparison arm was created based on a survey that included suggested treatment alternatives to EFTR of the respective lesions. Treatment costs and reimbursement were calculated in euro according to the coding rules of 2017 and 2019 (EFTR). R0 resection rate was used as a measure of effectiveness. To assess cost-effectiveness, the average cost-effectiveness ratio (ACER) and the incremental cost-effectiveness ratio (ICER) were determined. Calculations were made both from the perspective of the care provider as well as of the payer. - Results The cost per case was €2852.20 for the EFTR group, €1712 for the standard endoscopic resection (SER) group, €8895 for the surgical resection group and €5828 for the pooled alternative treatment to EFTR. From the perspective of the care provider, the ACER (mean cost per R0 resection) was €3708.98 for EFTR, €3115.10 for SER, €8924.05 for surgical treatment and €7169.30 for all pooled and weighted alternatives to EFTR. The ICER (additional cost per R0 resection compared with EFTR) was €5196.47 for SER, €26 533.13 for surgical resection and €67 768.62 for the pooled rate of alternatives. Results from the perspective of the payer were similar. - Conclusion EFTR is cost-effective in comparison with surgical and endoscopic treatment alternatives in the colorectum. | ||
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