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Cost-effectiveness of groin hernia repair from a randomized clinical trial comparing commercial versus low-cost mesh in a low-income country
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- Löfgren, Jenny (author)
- Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap
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- Matovu, A. (author)
- Karolinska Institutet
- Wladis, A. (author)
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- Ibingira, C. (author)
- Galiwango, E. (author)
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- (creator_code:org_t)
- 2017-02-16
- 2017
- English.
- In: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 104:6, s. 695-703
- Journal article (peer-reviewed)
Abstract
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- BackgroundOver 200 million people worldwide live with groin hernia and 20 million are operated on each year. In resource-scarce settings, the superior surgical technique using a synthetic mesh is not affordable. A low-cost alternative is needed. The objective of this study was to calculate and compare costs and cost-effectiveness of inguinal hernia mesh repair using a low-cost versus a commercial mesh in a rural setting in Uganda. MethodsThis is a cost-effectiveness analysis of a double-blinded RCT comparing outcomes from groin hernia mesh repair using a low-cost mesh and a commercially available mesh. Cost-effectiveness was expressed in US dollars (with euros in parentheses, exchange rate 30 December 2016) per disability-adjusted life-year (DALY) averted and quality-adjusted life-year (QALY) gained. ResultsThe cost difference resulting from the choice of mesh was $1247 (Euro1181). In the low-cost mesh group, the cost per DALY averted and QALY gained were $168 (Euro159) and $76 (Euro72) respectively. The corresponding costs were $582 (Euro551) and $333 (Euro315) in the commercial mesh group. A sensitivity analysis was undertaken including cost variations and different health outcome scenarios. The maximum costs per DALY averted and QALY gained were $1484 (Euro1405) and $847 (Euro802) respectively. ConclusionRepair using both meshes was highly cost-effective in the study setting. A potential cost reduction of over $120 (nearly Euro120) per operation with use of the low-cost mesh is important if the mesh technique is to be made available to the many millions of patients in countries with limited resources. Trial registration number: ISRCTN20596933 (). Mosquito mesh is cost-efficient
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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- Löfgren, Jenny
- Matovu, A.
- Wladis, A.
- Ibingira, C.
- Nordin, Pär
- Galiwango, E.
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- Forsberg, B. C.
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- MEDICAL AND HEALTH SCIENCES
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