A cost analysis of Nd: YAG Laser ablation versus endoscopic intubation for the palliation of malignant dysphagia

M. J. Sculpher, I. R. Sargeant, L. A. Loizou, S. M. Thorpe, G. M. Spencer, S. G. Bown

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Although endoscopic intubation is the mainstay of non-surgical palliation of malignant dysphagia, Nd:YAG laser ablation has been shown to provide good palliation with few complications. The study reported here incorporates data from published and unpublished sources into a cost model which estimates the lifetime cost of palliation with the two therapies. It is estimated that, depending on the assumptions used, laser palliation costs between £153 and £710 more per patient than endoscopie intubation. Sensitivity analysis is used to assess whether variation in clinical practice and in the unit costs of resources will change the conclusions of the study. This indicates that, under most alternative sets of assumptions, intubation retains its cost advantage. However, factors that might reduce, or even eliminate, this cost differential include undertaking more laser procedures as day-cases, using more expensive expanding metal stents for intubation and reducing the need for follow-up laser procedures with palliative radiotherapy.

Original languageEnglish
Pages (from-to)1640-1646
Number of pages7
JournalEuropean Journal of Cancer
Volume31
Issue number10
DOIs
Publication statusPublished - 1995

Keywords

  • costs
  • endoscopy
  • laser therapy
  • palliation

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