To compare costs and QoL associated with 2 minimally invasive operations to
treat uterovaginal prolapse. Study Design: A decision analytic cost-effectiveness
model comparing vaginal mesh hysteropexy to robotic-assisted sacrocolpopexy.
Costs were derived from a hospital perspective. QoL estimates focused on:
recurrent prolapse; erosion; infection; transfusion; cystotomy; chronic pain;
lower urinary tract symptoms; and mortality. Actual procedural costs at our
institution were calculated. Costs and quality adjusted life years were
examined over 1 year. Results: The costs
($21,853) and QALYs (0.9645) for robotic sacrocolpopexy produced a CE Ratio of
$22,657 per QALY. The costs ($14,890) and QALYs (0.9309) for vaginal
mesh produced a CE Ratio of $15,995 per QALY. The incremental cost per QALYs
for robotic surgery was $207,232. Sensitivity
analysis on all utilities, cost estimates, and complication estimates didn’t cross any thresholds. Conclusion: Vaginal
mesh was more cost-effective than robotic sacrocolpopexy even when the cost of
the robot was not factored.
Cite this paper
Culligan, P. , Salamon, C. , Lewis, C. and Abell, T. (2013) Cost-effectiveness analysis comparing robotic sacrocolpopexy to a vaginal mesh hysteropexy for treatment of uterovaginal prolapse. Open Journal of Obstetrics and Gynecology
, 613-620. doi: 10.4236/ojog.2013.38110
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