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

Abstract

ObjectiveThis study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.MethodDecision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.ResultsUsing 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.ConclusionA 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.

Tonsillectomy Outcomes for Coblation Versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis

“…A study conducted in the United Kingdom highlighted that coblation is a cost-effective intervention for tonsillectomy when compared with cold steel procedures for both adult and pediatric patients, with a probability of at least .7 at being costeffective. 24 In another study conducted in the United States, coblation was reported to have significantly lower costs compared to electrocautery surgery; however, the total cost of coblation was slightly higher when central supply was taken into account. 25 Based upon the results from the best available evidence comparing coblation tonsillectomy to bipolar diathermy in adult patients, there is no significant difference in the outcomes between the 2 techniques apart from more rapid healing of the tonsillar fossae in the coblation technique.…”

Tonsillectomy Outcomes for Coblation versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis

“…A study conducted in the United Kingdom highlighted that coblation is a cost-effective intervention for tonsillectomy when compared with cold steel procedures for both adult and paediatric patients, with a probability of at least 0.7 at being cost-effective 26 . In another study conducted in the United States, coblation was reported to have significantly lower costs compared to electrocautery surgery, however, the total cost of coblation was slightly higher when central supply was taken into account 27 .…”

Coblation versus Bipolar Diathermy Hemostasis in Pediatric Tonsillectomy Patients: Systematic Review and Meta-Analysis

“…However, when central supply is put into consideration the total cost of coblation is slightly higher 27 ($2,646 versus $2,591; P = 0.0011) with a difference of $55.94. However, because coblation is less likely to result in severe hemorrhage, it was found that using coblation tonsillectomy could save the National Health Service in the United Kingdom an incremental cost of £2000 for every avoided hemorrhage as opposed to using cold dissection with bipolar diathermy for haemostasis 28 . In a retrospective audit of 1,336 patients who had undergone coblation, it was reported that this technique had an increased requirement for operative intervention to manage secondary haemorrhage 29 .…”