Original Article
Cost and effectiveness of video-assisted thoracoscopic surgery for clinical stage I non-small cell lung cancer: a population-based analysis
Abstract
Background: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to conventional surgery (CS). We aimed to estimate the short-term cost-effectiveness of VATS vs. CS for clinical stage I non-small cell lung cancer (NSCLC-c-stage-I) patients from the payer’s perspective (National Health Insurance).
Methods: We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007- 2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was one year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment.
Results: Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4 [7] and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively.
Conclusions: We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (one year) within the common WTP levels in Taiwan.
Methods: We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007- 2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was one year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment.
Results: Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4 [7] and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively.
Conclusions: We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (one year) within the common WTP levels in Taiwan.
