Cost effectiveness of treatment for XXXX : an economic model for comparison of medical, minimally invasive, and surgical therapy.

@entity1 @entity1067 @entity458
PURPOSE: To evaluate the cost effectiveness of minimally invasive therapy relative to medical (alpha-blocker) therapy and transurethral resection (TURP) for @entity1 with moderate to severe symptoms of @entity1067 ( @entity1067 ). METHODS: We constructed a decision-analytic Markov model for a hypothetical cohort of 65-year-old @entity1 with moderate to severe @entity1067 symptoms. Microwave thermotherapy was selected to represent minimally invasive treatment. Cost-effectiveness analysis was performed with 25 health states using the 3 treatments, 5 short-term clinical events, and 17 possible long-term outcomes. Each health state had an associated cost and utility. Quality of life (QoL) and utility estimates were obtained by interviewing 13 @entity1 with @entity1067 symptoms using the standard gamble reference methods. @entity1 were classified as @entity458 ( @entity458 ) or non- @entity458 (NRA) on the basis of their attitudes to risk. We calculated the incremental cost effectiveness of microwave thermotherapy relative to medical therapy and TURP over 5 years after treatment initiation. Event probabilities were obtained from the literature, a consensus panel, and published randomized clinical trials. RESULTS AND CONCLUSIONS: The utility values generated were internally consistent and externally valid for a hypothetical cohort of 10,000 @entity458 @entity1 . Microwave thermotherapy was preferred by the NRA group, while medical therapy was preferred by the @entity458 group. Surgery was least preferred by both groups. Microwave thermotherapy had a small incremental cost but improved QoL in comparison with medical therapy. Microwave thermotherapy had a higher utility and lower cost than TURP and thus was dominant over TURP. This analytical method can be applied to evaluate the cost effectiveness of any @entity1067 therapy.
