Cost-effectiveness analysis of laparoscopic partial nephrectomy in Kazakhstan

Abstract

Objective: to assess cost-effectiveness of laparoscopic partial nephrectomy in comparison with open partial resection of the kidney in Kazakhstan.

Methods: A decision tree model was developed to simulate the clinical management of patients with an indication for partial kidney resection. In the model, patients used one of two technologies (laparoscopic and open). The time horizon was 1 year.

Results. According to the, there is a difference in the costs of laparoscopic partial nephrectomy (862,558 tenge) with open partial nephrectomy (388,038 tenge) by 2.2 times due to the initial high cost of the former, while, in terms of number of quality-adjusted years laparoscopic partial nephrectomy (0.734 QALY) has advantages over open partial nephrectomy (0.711 QALY). The ICUR of laparoscopic partial nephrectomy compared to open partial nephrectomy crossed the assumed willingness to pay threshold (three times the gross domestic product for 2019-2020 -11,000,000 tenge) and amounted to 20,474,809 tenge/QALY.

Conclusion. It is recommended to discuss the issue of revising the tariff for open partial nephrectomy (by 25% or higher), taking into account the increase in prices for drugs / medical devices and the costs associated with the stay of patients in the hospital.