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Cost-effectiveness of Coblation compared with cold steel tonsillectomies in the UK

Published online by Cambridge University Press:  24 January 2019

J F Guest ,
K Rana  and
C Hopkins
J F Guest*
Affiliation:
Catalyst Health Economics Consultants, Rickmansworth, UK Faculty of Life Sciences and Medicine, King's College, London, UK
K Rana
Affiliation:
Catalyst Health Economics Consultants, Rickmansworth, UK
C Hopkins
Affiliation:
ENT Department, Guy's and St Thomas’ NHS Foundation Trust, London, UK
*
Author for correspondence: Professor Julian F Guest, Catalyst Health Economics Consultants, 7 Gilham Court, Ebury Road, Rickmansworth WD3 1FZ, UK E-mail: [email protected] Fax: +44 (0)1923 450046
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Abstract

Objective

This study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.

Method

Decision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.

Results

Using a cold steel procedure instead of Coblation is expected to generate an incremental cost of more than £2000 for each additional avoided haemorrhage, and the probability of cold steel being cost-effective was approximately 0.50. Therefore, the cost-effectiveness of the two techniques was comparable. When the published clinical outcomes were replaced with clinicians’ estimates of current practice, Coblation was found to improve outcome for less cost, and the probability of Coblation being cost-effective was at least 0.70.

Conclusion

A best-case scenario suggests Coblation affords the National Health Service a cost-effective intervention for tonsillectomy in adult and paediatric patients compared with cold steel procedures. A worst-case scenario suggests Coblation affords the National Health Service an equivalent cost-effective intervention for adult and paediatric patients.

Keywords

CoblationCold DissectionTonsillectomyCost-EffectivenessAdultPediatricsUnited Kingdom
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 12 , December 2018 , pp. 1119 - 1127
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Prof J F Guest takes responsibility for the integrity of the content of the paper

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