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. 2024 Jan 7;15(1):1.
doi: 10.1186/s13244-023-01580-w.

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

José Antonio Narvaez  1   2 , Daniel Bernabeu  3 , Lorenzo Muntaner  4 , Fernando Gomez  5 , José Martel  6 , María Del Mar Castellano  7 , Raúl García-Marcos  8 , Reda Britel  4 , Itziar Oyagüez  9 , Nerea Tejado  10 , Eduardo Ortiz-Cruz  11
Affiliations

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

José Antonio Narvaez et al. Insights Imaging. .

Abstract

Background: Desmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain.

Methods: A cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (€ 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.

Results: The total cost for percutaneous cryoablation (€ 5774.78/patient-year) was lower than the total cost for conventional surgery (€ 6780.98/patient-year), yielding cost savings up to € 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results' robustness.

Conclusion: Percutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.

Critical relevance statement: This manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.

Key points: • Desmoid tumours are locally aggressive and may require local therapy. • Percutaneous cryoablation procedure is less invasive than the conventional surgery. • Cost comparison shows savings associated to percutaneous cryoablation use.

Keywords: Ablation techniques; Cryotherapy; Desmoid-type fibromatosis; Economic evaluation; Surgery.

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Conflict of interest statement

This analysis was developed with unrestricted financial support from Boston Scientific. IO and NT are employees of Pharmacoeconomics & Outcomes Research Iberia (PORIB), a consultant company specialising in health technology assessment, which has received financial support from Boston Scientific to conduct the development of the present work. JAN, DB and RGM declare proctoring in cryoablation for Boston Scientific. The remaining authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Estimation of the target population
Fig. 2
Fig. 2
Tornado diagram for one-way sensitivity analysis results. DRG, Diagnosis-Related Groups
See this image and copyright information in PMC

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