Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

Abstract

Desmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain.MethodsA cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (euro 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.ResultsThe total cost for percutaneous cryoablation (euro 5774.78/patient-year) was lower than the total cost for conventional surgery (euro 6780.98/patient-year), yielding cost savings up to euro 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results' robustness.ConclusionPercutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.Critical relevance statementThis manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use.