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A UK-based cost-utility analysis of radiofrequency ablation or oesophagectomy for the management of high-grade dysplasia in Barrett's oesophagus

Boger, P.C., Turner, D., Roderick, P. and Patel, P. (2010) A UK-based cost-utility analysis of radiofrequency ablation or oesophagectomy for the management of high-grade dysplasia in Barrett's oesophagus Alimentary Pharmacology & Therapeutics, 32, (11-12), pp. 1332-1342. (doi:10.1111/j.1365-2036.2010.04450.x).

Record type: Article

Abstract

Background: in the UK, oesophagectomy is the current recommendation for patients with persistent high-grade dysplasia in Barrett’s oesophagus. Radiofrequency ablation is an alternative new technology with promising early trial results.

Aim: to undertake a cost–utility analysis comparing these two strategies.

Methods: we constructed a Markov model to simulate the natural history of a cohort of patients with high-grade dysplasia in Barrett’s oesophagus undergoing one of two treatment options: (i) oesophagectomy or (ii) radiofrequency ablation followed by endoscopic surveillance with oesophagectomy for high-grade dysplasia recurrence or persistence.

Results: in the base case analysis, radiofrequency ablation dominated as it generated 0.4 extra quality of life years at a cost saving of £1902. For oesophagectomy to be the most cost-effective option, it required a radiofrequency ablation treatment failure rate (high-grade dysplasia persistence or progression to cancer) of >44%, or an annual risk of high-grade dysplasia recurrence or progression to cancer in the ablated oesophagus of >15% per annum. There was an 85% probability that radiofrequency ablation remained cost-effective at the NICE willingness to pay threshold range of £20 000–30 000.

Conclusion: radiofrequency ablation is likely to be a cost-effective option for high-grade dysplasia in Barrett’s oesophagus in the UK.

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Published date: December 2010

Identifiers

Local EPrints ID: 175657
URI: http://eprints.soton.ac.uk/id/eprint/175657
ISSN: 0269-2813
PURE UUID: 380fdf89-50d3-473a-b45e-b66c0f69ef45
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 25 Feb 2011 10:23
Last modified: 12 Jul 2017 16:33

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Contributors

Author: P.C. Boger
Author: D. Turner
Author: P. Roderick ORCID iD
Author: P. Patel

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