Cost-Effectiveness of Topical Prophylaxis Against Tympanostomy Tube Otorrhea: An Economic Decision Analysis

Grant Conner, Yuki Yoshiyasu, Nicholas Rossi, Brian McKinnon

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Article numbere168
Pages (from-to)e168
JournalOTO Open
Volume8
Issue number3
DOIs
StatePublished - Jul 1 2024
Externally publishedYes

Keywords

  • cost-effectiveness
  • postop otorrhea
  • tympanostomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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