Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

Kowalczyk, David M.; Jordan, James; Stringer, Scott P.

doi:10.1002/lary.27182

Cited by 8 publications

(14 citation statements)

References 38 publications

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“…A simple duct incision and stone removal are thus recommendable in ambulatory cases where the stone is palpable and distally located. Recently, Kowalczyk et al [26] showed in a cost-effectiveness analysis based on a literature review that the upfront sialendoscopy is a more cost-effective treatment in radioiodine-induced sialadenitis than medical management utilizing ultrasound when the willingness-to-pay threshold is $50 000.…”

Section: Discussionmentioning

confidence: 99%

Costs of sialendoscopy and impact on health-related quality of life

Jokela

Saarinen

Mäkitie

et al. 2018

Eur Arch Otorhinolaryngol

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PurposeTo analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study.MethodsAll patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1 year before to 1 year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3 months were mailed to the patients before sialendoscopy as well as at 3 and 12 months after the operation.ResultsA total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions “discomfort and symptoms” and “distress” were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension “discomfort and symptoms” improved significantly at 3 and 12 months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3 months postoperatively.ConclusionsThe costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients’ discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.

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Section: Discussionmentioning

confidence: 99%

Costs of sialendoscopy and impact on health-related quality of life

Jokela

Saarinen

Mäkitie

et al. 2018

Eur Arch Otorhinolaryngol

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“…Auch Kliniken, die eine Sialendoskopie selbst nicht anbieten, scheinen den Nutzen der Sialendoskopie als diagnostische und therapeutische Maßnahme zu erkennen und halten die Kosten des Eingriffs für gerechtfertigt. Erste systematische Kosten-Nutzen-Analysen zur Sialendoskopie existieren, diese allerdings nicht für das deutsche Krankenkassensystem [14,15]. Diese Untersuchungen zeigen, dass eine angemessene Kosten-Nutzen-Relation für die chronisch obstruktive Sialadenitis besteht.…”

Section: Diskussionunclassified

“…Dies ist bei der alleinigen Lavage des Gangsystems mittels Katheter nicht möglich. Zu beachten ist ferner, dass beide Publikationen aus den USA stammen [14,15]. Kosten-Nutzen-Relationsuntersuchungen aus den USA sind aufgrund unterschiedlicher Versorgungssysteme nicht unmittelbar auf Deutschland zu übertragen.…”

Section: Diskussionunclassified

Stellenwert der Sialendoskopie an deutschen HNO-Kliniken im Jahr 2016

et al. 2018

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Zusammenfassung Hintergrund Eine Umfrage aus dem Jahr 2009 zeigte, dass lediglich etwa 24 % aller deutschen HNO-Kliniken die Sialendoskopie anboten. Durch die Wiederholung der Untersuchung im Jahr 2016 sollte die Entwicklung der Sialendoskopie an deutschen HNO-Kliniken reevaluiert werden. Material und Methoden Erneut wurde ein selbstentwickelter Fragebogen mit elf Fragen an alle deutschen HNO-Kliniken verschickt. Der gleiche Fragebogen wurde bereits im Jahr 2009 verwendet. Die aktuellen Umfrageergebnisse wurden mit den Ergebnissen von damals verglichen und ausgewertet. Ergebnisse Die Zahl der sialendoskopierenden HNO-Kliniken konnte sich mehr als verdoppeln. Die Anzahl der Interventionen verdreifachte sich. Die Gründe dafür, dass eine Klinik keine Sialendoskopien durchführte, waren verschieden. Ein Hauptargument war ein Mangel an Patienten. Kaum Veränderungen ergaben sich bei ambulanten und stationären Therapien und der Eingriffsdauer. Die Sonografie wird unverändert von allen Kliniken präoperativ durchgeführt. Schlussfolgerung Auffallend ist, dass bei zunehmender Anzahl an Kliniken, die die Sialendoskopie anbieten und steigenden Fallzahlen, ein Teil der Kliniken einen Patientenmangel angibt. Dies könnte für die Etablierung von spezialisierten Zentren sprechen. Inzwischen werden neben der obstruktiven Sialadenitis weitere Krankheitsbilder durch die Sialendoskopie therapiert. Die Sonografie bleibt die präoperative Diagnostik der Wahl. Die Auswertung zeigt, dass die Sialendoskopie in den vergangenen sieben Jahren eine steigende Akzeptanz an deutschen HNO-Kliniken erfahren hat.

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“…Probabilities of long-term complications and recurrent sialolithiasis after sialendoscopy were also incorporated into the model. 2,10…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

Acevedo

Hsu

et al. 2021

Otolaryngol.--head neck surg.

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Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

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Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

Abstract: NA. Laryngoscope, 1822-1828, 2018.

Cited by 8 publications

References 38 publications

Costs of sialendoscopy and impact on health-related quality of life

Costs of sialendoscopy and impact on health-related quality of life

Stellenwert der Sialendoskopie an deutschen HNO-Kliniken im Jahr 2016

Cost‐effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

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