Cost-effectiveness analysis of using the heat and moisture exchangers compared with alternative stoma covers in laryngectomy rehabilitation: US perspective

Ann Jean C.C. Beck*, Valesca P. Retèl, Glenn Bunting, Rosh K.V. Sethi, Daniel G. Deschler, Michiel W.M. van den Brekel, Wim H. van Harten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: This study aims to evaluate the cost-effectiveness of using heat and moisture exchangers (HMEs) vs alternative stoma covers (ASCs) following laryngectomy in the United States. Methods: A cost-effectiveness and budget impact analysis were conducted including uncertainty analyses using real-world survey data with pulmonary events and productivity loss. Results: HME use was more effective and less costly compared with ASCs. Quality-adjusted life years were slightly higher for HME-users. Total costs per patient (lifetime) were $59 362 (HME) and $102 416 (ASC). Pulmonary events and productivity loss occurred more frequently in the ASC-users. Annual budget savings were up to $40 183 593. Costs per pulmonary event averted were $3770. Conclusions: HME utilization in laryngectomy patients was cost-effective. Reimbursement of HME devices is thus recommended. Utilities may be underestimated due to the generic utility instrument used and sample size. Therefore, we recommend development of a disease-specific utility tool to incorporate in future analyses.

Original languageEnglish
Pages (from-to)3720-3734
Number of pages15
JournalHead and Neck
Volume42
Issue number12
Early online date4 Sep 2020
DOIs
Publication statusPublished - Dec 2020

Keywords

  • cost-effectiveness analysis
  • heat and moisture exchanger
  • pulmonary rehabilitation
  • reimbursement
  • total laryngectomy

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