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Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery.

Publication ,  Journal Article
Dainty, L; Maxwell, GL; Clarke-Pearson, DL; Myers, ER
Published in: Gynecol Oncol
May 2004

OBJECTIVE: To compare the cost-effectiveness of external pneumatic compression devices with and without the addition of low-molecular-weight heparin for the prevention of deep vein thrombosis in high-risk surgical patients with gynecologic cancer. METHODS: A Markov decision analytic model was used to estimate the costs and outcomes associated with the prophylactic use of external pneumatic compression with and without low-molecular-weight heparin in patients undergoing gynecologic surgery. We estimated cost per fatal pulmonary embolus prevented, cost per deep vein thrombus prevented, and cost per life-year saved. Probability estimates for various outcomes and efficacies were obtained from the literature, using data specific for gynecologic surgery patients when available. RESULTS: In the base case scenario, cost-effectiveness estimates for combination prophylaxis varied from 10,091 dollars per life-year saved for a 35-year-old patient with IB cervix cancer patient to 50,181 dollars for a 65-year-old patient with stage IIIC ovarian cancer, costs within the 50,000-65,000 dollars per life-year saved threshold considered to be cost-effective. Combination prophylaxis appeared to be cost-effective in gynecologic oncology patients as long as the risk of perioperative thromboembolism using this method of prevention was less than or equal to 4%. Sensitivity analysis indicated that variation of the marginal cost of low-molecular-weight heparin and the marginal effectiveness to extremes did not change the conclusions of the statistical model. CONCLUSION: The use of combination therapy external pneumatic compression is estimated to be cost-effective for high-risk gynecologic oncology patients undergoing surgery. Clinical trials to determine the efficacy of perioperative combination therapy in gynecologic surgery are justified.

Duke Scholars

Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

May 2004

Volume

93

Issue

2

Start / End Page

366 / 373

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Uterine Cervical Neoplasms
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Humans
  • Heparin, Low-Molecular-Weight
  • Gynecologic Surgical Procedures
  • Gravity Suits
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dainty, L., Maxwell, G. L., Clarke-Pearson, D. L., & Myers, E. R. (2004). Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery. Gynecol Oncol, 93(2), 366–373. https://doi.org/10.1016/j.ygyno.2004.02.004
Dainty, L., G. L. Maxwell, D. L. Clarke-Pearson, and E. R. Myers. “Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery.Gynecol Oncol 93, no. 2 (May 2004): 366–73. https://doi.org/10.1016/j.ygyno.2004.02.004.
Dainty L, Maxwell GL, Clarke-Pearson DL, Myers ER. Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery. Gynecol Oncol. 2004 May;93(2):366–73.
Dainty, L., et al. “Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery.Gynecol Oncol, vol. 93, no. 2, May 2004, pp. 366–73. Pubmed, doi:10.1016/j.ygyno.2004.02.004.
Dainty L, Maxwell GL, Clarke-Pearson DL, Myers ER. Cost-effectiveness of combination thromboembolism prophylaxis in gynecologic oncology surgery. Gynecol Oncol. 2004 May;93(2):366–373.
Journal cover image

Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

May 2004

Volume

93

Issue

2

Start / End Page

366 / 373

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Uterine Cervical Neoplasms
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Humans
  • Heparin, Low-Molecular-Weight
  • Gynecologic Surgical Procedures
  • Gravity Suits
  • Female