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

• Published in: Head & neck 2020-12, Vol.42 (12), p.3720-3734
• Main Authors: Beck, Ann‐Jean C. C., Retèl, Valesca P., Bunting, Glenn, Sethi, Rosh K. V., Deschler, Daniel G., Brekel, Michiel W. M., Harten, Wim H.
• Format: Article
• Language: English
• Subjects: Cost control; cost‐effectiveness analysis; Head and neck; heat and moisture exchanger; Ostomy; pulmonary rehabilitation; Rehabilitation; reimbursement; total laryngectomy
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26442

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.