Abstract

GUEVARA, César Augusto  and  TAKEUCHI, Yuri. Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome Treated at a Tertiary Center in Cali, Colombia. Rev. Cienc. Salud [online]. 2015, vol.13, n.2, pp.125-140. ISSN 1692-7273.  https://doi.org/10.12804/revsalud13.02.2015.01.

Introduction: Although there are several treatments for carpal tunnel syndrome -cts-, the efficiency of these has not yet been evaluated in Colombia. Objective: Determine the incremental cost-utility ratio -icur- of medical and surgical treatment in patients with cts. Material and methods: A cost-utility analysis was conducted from the societal perspective with patients older than 18 years diagnosed with cts who received medical or surgical treatment. Quality-adjusted life-years (-qalys- were calculated using the EQ-5d. Costs were obtained from the iss national tariff 2001+30%.The results were extrapolated to long term figures through a Markov model with a discount rate of 3.5%.A probabilistic sensitivity analysis using Monte Carlo simulation was performed. Results: Fifty-three patients participated, women (71.7%); mean age: 55.5 years. 79% of patients received medical treatment.The most frequent treatment was medical observation (66.7%) and nsaids (16.6%). Medical treatment provided 0.33 qalys (± 0.11) and surgery 0.37 (± 0.10). The average total cost of medical treatment at six months and 20 years was COP 132006 (95% CI: COP 70255-425341) and COP 483440 (95% CI: COP 104310-862570) respectively.The cost of surgery was COP 1972644 (95% CI: COP 981204-8517065) and COP 979585 (95%:COP 684912-1274258). Surgery was dominated by six months. icur at 20 years was COP 1033635/ QALY additional (95% CI: COP 840179- 1235323/additional QALY), with a 80% of probability that surgery be cost-useful when willingness to pay COP 5000000 is achieved. Conclusion: Medical treatment is more cost-effective than surgery in the short term. However, in the long term, surgery is more cost-effective than the medical treatment.

Keywords : Carpal tunnel syndrome; costs and costs analysis; cost-benefit analysis; quality of life.

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