Cost-effectiveness analysis of endoscopic eradication therapy for treatment of high-grade dysplasia in Barrett's esophagus

J Comp Eff Res. 2017 Jul;6(5):425-436. doi: 10.2217/cer-2016-0089. Epub 2017 May 25.

Abstract

Aim: The aim was to evaluate the cost-effectiveness of endoscopic eradication therapy (EET) with combined endoscopic mucosal resection and radiofrequency ablation for the treatment of high-grade dysplasia (HGD) arising in patients with Barrett's esophagus compared with endoscopic surveillance alone in the UK.

Materials & methods: The cost-effectiveness model consisted of a decision tree and modified Markov model. A lifetime time horizon was adopted with the perspective of the UK healthcare system.

Results: The base case analysis estimates that EET for the treatment of HGD is cost-effective at a GB£20,000 cost-effectiveness threshold compared with providing surveillance alone for HGD patients (incremental cost-effectiveness ratio: GB£1272).

Conclusion: EET is likely to be a cost-effective treatment strategy compared with surveillance alone in patients with HGD arising in Barrett's esophagus in the UK.

Keywords: Barrett’s esophagus; cost–effectiveness; dysplasia; endoscopic procedures; health economics.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Barrett Esophagus / economics*
  • Barrett Esophagus / surgery
  • Catheter Ablation / economics*
  • Catheter Ablation / methods
  • Cost-Benefit Analysis
  • Esophagoscopy / economics*
  • Esophagoscopy / methods
  • Health Care Costs
  • Humans
  • Middle Aged
  • Quality of Life
  • Quality-Adjusted Life Years
  • Treatment Outcome