Health economic evaluation of different treatment strategies for peripheral entrapment mononeuropathies: a systematic review

ABSTRACT

Introduction: In this era of cost-conscious health systems, it is of utmost importance to identify and establish the most cost-effective treatment option. However, in the case of peripheral entrapment mononeuropathies there is alack of data regarding economically effective treatment strategies. Therefore, the objective was to conduct an economic evaluation including both costs and benefits of various treatment strategies applied to peripheral entrapment mononeuropathies to estimate the relative cost-effective treatment regimens.

Areas covered: Over the 19 years, seven excellent-high quality economic evaluations of three types of peripheral entrapment mononeuropathies were identified in four countries. Our findings showed that surgery was the most cost-effective therapy followed by same cost efficacy of infiltrative therapy and conservative therapy for peripheral entrapment mononeuropathies. However, the fact that surgery was the most common comparator (n = 6) in our selected studies cannot be neglected.

Expert opinion: Due to huge methodological variability, the finding of surgery as the cost-effective treatment strategy remains tentative and the decision about the most suitable clinical and cost-effective therapy should be individualized from case to case. Moreover, the economic evaluation of all possible treatment strategies for peripheral entrapment mononeuropathies over alonger period of analysis is required in future studies.

KEYWORDS:

• Peripheral entrapment mononeuropathies
• health economic evaluation
• surgery
• infiltrative therapy
• conservative therapy

Article highlights

• This is the first systematic review which critically assesses the economic implications of peripheral entrapment mononeuropathies, all of the included studies were of excellent-high quality as per Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, performed in the US, UK, Netherlands, and Spain.

• According to our findings, surgery if considered as first-line therapy for peripheral entrapment mononeuropathies demonstrates a more favorable economic perspective. However, due to huge methodological variability between selected studies we could not conclude surgery to be chosen as the first therapeutic option for peripheral entrapment mononeuropathies and we recommend selecting therapy on a case by case basis.

• Our review will help researchers and decision-makers to identify gaps in the health/economic context of peripheral entrapment mononeuropathies and inform future economic evaluations to draw a more authentic conclusion about cost-effective treatment strategies for peripheral entrapment mononeuropathies.

Reviewers disclosure

Peer reviewers of this manuscript have no relevant financial relationships or otherwise to disclose.

Declaration of interest

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.