Abstract
OBJECTIVE: To evaluate the cost-effectiveness of various topical prophylaxis strategies against posttympanostomy otorrhea using a break-even analysis.
STUDY DESIGN: An economic decision analysis of data collected from purchasing records and the literature.
SETTING: An academic center.
METHODS: Costs of various strategies were calculated by querying our institution's pharmacy as well as GoodRX.com drug prices. Posttympanostomy otorrhea rates were acquired from a review of the literature. Costs for treatment of otorrhea were based upon our institution's self-pay patient charges. A break-even analysis was performed to determine the required absolute risk reduction ( ARR ) in otorrhea rate to make prophylactic treatment cost-effective.
RESULTS: The most expensive strategy ciprofloxacin/hydrocortisone otic ($626.83) was not cost-effective unless the rate of postoperative otorrhea was greater than 92% or if the cost of otorrhea treatment exceeded $4477.36. The cheapest antibiotic/steroid combination, ciprofloxacin/dexamethasone otic ($72.25) was cost-effective ( ARR 10%). Using a conservative initial otorrhea rate (14%) and weighted cost of treatment ($683.39), the most expensive cost-effective prophylactic intervention possible was $95.67.
CONCLUSION: Prophylaxis against posttympanostomy otorrhea can be cost-effective. Physicians should consider the cost of prophylaxis at their institution as well as the patient's postoperative risk of otorrhea when making treatment decisions.
Original language | English (US) |
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Article number | e168 |
Pages (from-to) | e168 |
Journal | OTO Open |
Volume | 8 |
Issue number | 3 |
DOIs | |
State | Published - Jul 1 2024 |
Externally published | Yes |
Keywords
- cost-effectiveness
- postop otorrhea
- tympanostomy
ASJC Scopus subject areas
- Surgery
- Otorhinolaryngology