Laparoscopic appendectomy appears to be cost effective for acute appendicitis in Colombia

Abstract

Laparoscopic appendectomy appears to be the most cost-effective option, compared with non-operative management and open appendectomy, in adult patients with uncomplicated acute appendicitis in Colombia, according to research published in Cost Effectiveness and Resource Allocation. The researchers constructed a model using data from a literature review to compare the costs and utilities of three interventions (laparoscopic appendectomy versus open appendectomy versus non-operative management) for treating adults (18 to 60 years old) with uncomplicated acute appendicitis from a Colombian public payer perspective. Direct costs were estimated from local tariffs and other sources. A discount rate of 5% was applied to future costs and quality-adjusted life years (QALYs). Over a 5-year time horizon, laparoscopic appendectomy resulted in lower costs ($363 ± 35) than open appendectomy and non-operative management ($US363 versus $384 and $392, respectively). Non-operative management resulted in higher QALYs (3.3332) than laparoscopic appendectomy (3.3310) and open appendectomy (3.3261). Laparoscopic appendectomy dominated (was less expensive and more effective than) open appendectomy. When comparing laparoscopic appendectomy with non-operative management, the incremental cost-effectiveness ratio was $24 000 per QALY. Further analyses showed that laparoscopic appendectomy had a 52% probability of generating the highest net monetary benefit (NMB), compared with the other two interventions. The mean value of the incremental NMB was $93.7 per patient. The authors conclude that LA [laparoscopic appendectomy] has a high probability of producing more significant monetary benefits than NOM [non-operative management] and OA [open appendectomy] from the payer’s perspective in the Colombian health system.