Imperial College London
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Professor Hesham Saleh

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Rhinology)
 
 
 
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Contact

 

+44 (0)20 3311 1025h.saleh Website

 
 
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Location

 

Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Javanbakht:2020:10.1007/s41669-020-00198-8,
author = {Javanbakht, M and Saleh, H and Hemami, MR and Branagan-Harris, M and Boiano, M},
doi = {10.1007/s41669-020-00198-8},
journal = {PharmacoEconomics - Open},
pages = {679--686},
title = {A corticosteroid-eluting sinus implant following endoscopic sinus surgery for chronic rhinosinusitis: a UK-based cost-effectiveness analysis.},
url = {http://dx.doi.org/10.1007/s41669-020-00198-8},
volume = {4},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Chronic rhinosinusitis (CRS) is one of the commonest chronic health problems among adults in the UK. Around 15% of CRS patients undergo functional endoscopic sinus surgery (FESS) annually after failing medical treatment. However, as incomplete resolution of symptoms or complications post-operatively is common, the post-operative management is considered to be as important as the surgery itself. A bioabsorbable corticosteroid-eluting sinus implant (CESI) (Propel®, mometasone furoate 370 µg) has been used as an alternative post-FESS treatment. OBJECTIVE: The objective of this study was to assess the cost effectiveness of the corticosteroid-eluting implant versus non-corticosteroid-eluting spacer following FESS for treatment of patients with CRS. METHODS: A decision tree model was developed to estimate the cost and effectiveness in each strategy. Costs and effects were estimated from a UK National Health Service (NHS) and personal social services perspective over a 6-month time horizon. Model pathways and parameters were informed by existing clinical guidelines and literature and sensitivity analyses were conducted to explore uncertainties in base-case assumptions. RESULTS: Over a 6-month time horizon, inserting CESI at the end of FESS is less costly (£4646 vs. £4655 per patient) and is the more effective intervention [total quality-adjusted life-years (QALYs) over 6 months 0.443 vs. 0.444] than non-corticosteroid-eluting spacers; hence, it is a dominant strategy. The probabilistic analysis results indicate that CESI following FESS has a 62% probability of being cost effective at the £20,000/per QALY willingness-to-pay threshold and 56% probability of being a cost-saving intervention. CONCLUSIONS: The use of CESI after FESS results in fewer post-operative complications than non-corticosteroid-eluting implants and may be a cost-saving technology over a 6-month time horizon. Although the cost of initial treatment with the
AU  - Javanbakht,M
AU  - Saleh,H
AU  - Hemami,MR
AU  - Branagan-Harris,M
AU  - Boiano,M
DO  - 10.1007/s41669-020-00198-8
EP  - 686
PY  - 2020///
SN  - 2509-4254
SP  - 679
TI  - A corticosteroid-eluting sinus implant following endoscopic sinus surgery for chronic rhinosinusitis: a UK-based cost-effectiveness analysis.
T2  - PharmacoEconomics - Open
UR  - http://dx.doi.org/10.1007/s41669-020-00198-8
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32048233
UR  - https://link.springer.com/article/10.1007/s41669-020-00198-8
UR  - http://hdl.handle.net/10044/1/98090
VL  - 4
ER  -
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