Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery

ABSTRACT

Background: An evaluation was conducted to estimate the cost-effectiveness of insufflation of warmed humidified CO₂ during open and laparoscopic colorectal surgery compared with usual care from a UK NHS perspective.

Methods: Decision analytic models were developed for open and laparoscopic surgery. Incremental costs per quality-adjusted life year (QALY) were estimated. The open surgery model used data on the incidence of intra-operative hypothermia and applied risks of complications for hypothermia and normothermia. The laparoscopic surgery model utilised data describing complications directly. Sensitivity analyses were conducted.

Results: Compared with usual care, insufflation of warmed humidified CO₂ dominated. For open surgery, savings of £20 and incremental QALYs of 0.013 were estimated per patient. For laparoscopic surgery, savings of £345 and incremental QALYs of 0.001 per patient were estimated. Results were robust to most sensitivity analyses.

Conclusions: Considering the current evidence base, the intervention is likely to be cost-effective compared with usual care in patients undergoing colorectal surgery.

KEYWORDS:

• Cost utility analysis
• economic evaluation
• colorectal surgery
• hypothermia

Acknowledgments

The authors are grateful to The ICENI Centre (Colchester Hospital University Foundation Trust and Anglia Ruskin University) for providing clinical data to populate the economic model.

Disclosure statement

In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that I receive funding from a company that may be affected by the research reported in the enclosed paper. I have disclosed those interests fully to Taylor & Francis, and I have in place an approved plan for managing any potential conflicts arising from that involvement.

Declaration of interest

All authors are employed by York Health Economics Consortium Ltd. and received funding for health economics consultancy from Fisher & Paykel Healthcare, manufacturers of the HumiGard device. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Supplementary material

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Additional information

Funding

This manuscript was funded by Fisher & Paykel Healthcare Ltd.