Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia

DOI:  https://doi.org/10.12804/revsalud13.02.2015.01

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Issue: Vol. 13 No. 02 (2015)
Section Clinical or Experimental Research


Keywords: Carpal tunnel syndrome , costs and costs analysis , cost-benefit analysis , quality of life Síndrome do túnel do carpo , custos e análise de custos , análise custo-benefício , qualidade de vida. Síndrome de túnel carpiano , costos y análisis de costos , análisis costo-beneficio , calidad de vida.

Main Article Content

Authors

César Augusto Guevara
Yuri Takeuchi

Abstract

Introduction: Although there are several treatments for carpal tunnel syndrome (CTS), the efficiency of these has not evaluated in Colombia. Objective: Determine the incremental cost-utility ratio (ICUR) of medical and surgical treatment in patients with CTS. Material and methods: A cost utility analysis was conducted from the societal perspective with patients older than 18 years
diagnosed with CTS who received medical or surgical treatment. Quality-adjusted life-years (QALYs) were calculated using the EQ-5D. Costs were obtained from the ISS national tariff 2001+30 %. The results were extrapolated to long term through a Markov model with a discount rate of 3,5 %. A probabilistic sensitivity analysis using Monte Carlo simulation was performed.
Results: Fifty- three patients participated, women (71,7 %); mean age: 55,5 years. 79 % of patients received medical treatment. The most frequent treatment was medical observation (66,7 %) and NSAIDs (16,6 %). Medical treatment provided 0,33 QALYs (± 0,11) and surgery 0,37 (± 0,10).
The average total cost of medical treatment at 6 months and 20 years was COP 132 006 (95 % CI: COP 70 255 - 425 341) and COP 483 440 (95 % CI: COP 104 310 - 862 570) respectively. The cost of surgery was COP 1 972 644 (95 % CI: COP 981 204 - 8 517 065) and COP 979 585 (95 %: COP 684 912 - 1 274 258). The surgery was dominated by 6 months. The ICUR at 20 years was COP
1 033 635/QALY additional (95 % CI: COP 840 179 - 1 235 323/additional QALY) with a 80 % of probability that surgery be cost-utility when there is a willingness to pay COP 5 000 000. Conclusion: The medical treatment is cost-effective with regard to the surgery in short term. However, in the long term the surgery is cost effective with respect to the medical treatment.

How to Cite
Guevara, C. A., & Takeuchi, Y. (2015). Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia. Revista Ciencias De La Salud, 13(02), 125–140. https://doi.org/10.12804/revsalud13.02.2015.01
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