Cost-effectiveness analysis of endoscopic tympanoplasty versus microscopic tympanoplasty for chronic otitis media in Taiwan

Chih Chieh Tseng, Ming Tang Lai, Chia Che Wu, Sheng Po Yuan, Yi Fang Ding

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Health care systems and physicians need to conform to budgets and streamline resources to provide cost-effective quality care. Although endoscopic tympanoplasty (ET) has been performed for decades, no studies on the cost-effectiveness of ET and microscopic tympanoplasty (MT) for treating chronic otitis media have been published. The present study aimed to compare the cost-effectiveness of ET and MT for treating chronic otitis media. Methods: This study was performed using a Cohort-style Markov decision-tree economic model with a 30-year time horizon. The economic perspective was that of a third-party payer (Taiwan National Health Insurance System). Two treatment strategies were compared, namely ET and MT. The primary outcome was the incremental cost per quality-adjusted life year (QALY). Probabilities were obtained from meta-analyses. Costs were obtained from the published literature and Taiwan National Health Insurance System database. Multiple sensitivity analyses were performed to account for data uncertainty. Results: The reference case revealed that the total cost of ET was $NT 20,901 for 17.08 QALY per patient. By contrast, the total cost of MT was $NT 21,171 for 17.15 QALY per patient. The incremental cost effectiveness ratio for ET versus that of MT was $NT 3703 per QALY. The cost-effectiveness acceptability curve indicated that ET was comparable to MT at a willingness-to-pay threshold of larger than $NT 35,000 per QALY. Conclusion: This cost-effectiveness analysis indicates that ET is comparable to MT for treating chronic otitis media in Taiwan. This result provides the latest information for physicians, the government, and third-party payers to select proper clinical practice.

Original languageEnglish
JournalJournal of the Chinese Medical Association
DOIs
Publication statusAccepted/In press - Jan 1 2017

Fingerprint

Tympanoplasty
Otitis Media
Taiwan
Cost-Benefit Analysis
Quality-Adjusted Life Years
Costs and Cost Analysis
Health Insurance Reimbursement
National Health Programs
Economic Models
Physicians
Decision Trees
Quality of Health Care
Budgets

Keywords

  • Chronic otitis media
  • Cost effectiveness
  • Endoscopy
  • Microscopy
  • Tympanoplasty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cost-effectiveness analysis of endoscopic tympanoplasty versus microscopic tympanoplasty for chronic otitis media in Taiwan. / Tseng, Chih Chieh; Lai, Ming Tang; Wu, Chia Che; Yuan, Sheng Po; Ding, Yi Fang.

In: Journal of the Chinese Medical Association, 01.01.2017.

Research output: Contribution to journalArticle

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