Laparoscopic hysterectomy is not cost effective compared with vaginal hysterectomy |
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| Affiliation: | 1. Queensland University of Technology, School of Public Health, Institute of Health and Biomedical Innovation, QLD, Australia;2. University of Sydney NHMRC Clinical Trials Centre, Sydney, NSW, Australia;3. University of Newcastle, Priority Research Centre for Gender Health and Ageing, Newcastle, NSW, Australia;4. Westmead Hospital, Department of Gynaecologic Oncology, Sydney, NSW, Australia;5. Box Hill Hospital, Melbourne, VIC, Australia;6. Queensland Centre for Gynaecological Cancer, QLD, Australia |
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| Abstract: | ![]()
QuestionWhat is the cost effectiveness of laparoscopic hysterectomy compared with conventional (vaginal or abdominal) hysterectomy?Study designTwo parallel multicentre randomised controlled trials.Main results Vaginal hysterectomy:Laparoscopic hysterectomy was significantly more expensive than vaginal hysterectomy, however there were no differences in quality adjusted life years (QALYs; see Table 1).Abdominal hysterectomy:There were no significant differences between abdominal and laparoscopic hysterectomy for cost or QALYs. For each additional QALY, laparoscopic hysterectomy was estimated to cost £267,333 more than vaginal hysterectomy, and £26,571 more than abdominal hysterectomy.| Table 1 Relative cost and effectiveness of laparoscopic versus conventional hysterectomy techniques (£ sterling at 1999/2000 rates). | | Comparison | Mean difference in cost (95% CI) | Mean difference in QALYs (95% CI) | ICER | | Laparoscopic vs vaginal | £401 (271 to 542) | 0.0015(–0.0015 to 0.018) | £267,333 | | Laparoscopic vs abdominal | £186 (–26 to +375) | 0.007(–0.008 to 0.023) | £26,571 |
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