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Cost minimization analysis of laparoscopic sacral colpopexy and total vaginal mesh

Published:December 19, 2011DOI:https://doi.org/10.1016/j.ajog.2011.12.012

      Objective

      The objective of the study was a cost minimization analysis of the laparoscopic sacral colpopexy (LSC) and total vaginal mesh (TVM).

      Study Design

      Primary clinical costs were derived from our randomized control trial comparing LSC and TVM and were compared using prices from privately- and publicly-conducted procedures. Womens' opportunity cost of time were added to these estimates to produce estimates of the primary economic costs of the procedures. Reoperation costs were added to estimate the economic cost per subject.

      Results

      LSC has lower mean primary clinical cost as compared with the TVM in both the public (mean difference, $1102.96; 95% confidence interval [CI], 468.52–1737.385) and private models (mean difference, $1176.68; 95% CI, 1116.85–1236.51), respectively. Mean total economic costs were significantly lower in the LSC group as compared with the TVM ($4013.07; 95% CI, 3107.77–4918.37). Labor costs were significantly greater in the LSC but were offset by lower consumable, inpatient, opportunity, and reoperation costs as compared with the TVM.

      Conclusion

      The LSC has lower economic cost than TVM.

      Key words

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      Linked Article

      • Cost minimization minilaparotomy vs laparoscopic sacral colpopexy
        American Journal of Obstetrics & GynecologyVol. 207Issue 2
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          I read with interest the paper entitled “Cost minimization analysis of laparoscopic sacral colpopexy and total vaginal mesh” by Drs Christopher F. Maher and Luke B. Connelly.1 The paper focused on cost containment for the treatment of uterine prolapse. I noticed that the authors considered laparoscopy vs the total mesh vaginal approach. This very well-done study did not mention the inexpensive minilaparotomy approach.
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