caa a22 4500 606183701 CHVBK 20210128100822.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00405-015-3618-5 doi (NATIONALLICENCE)springer-10.1007/s00405-015-3618-5 Cost-effectiveness of heat and moisture exchangers compared to usual care for pulmonary rehabilitation after total laryngectomy in Poland [Elektronische Daten] [Valesca Retèl, Cindy van den Boer, Lotte Steuten, Sławomir Okła, Frans Hilgers, Michiel van den Brekel] The beneficial physical and psychosocial effects of heat and moisture exchangers (HMEs) for pulmonary rehabilitation of laryngectomy patients are well evidenced. However, cost-effectiveness in terms of costs per additional quality-adjusted life years (QALYs) has not yet been investigated. Therefore, a model-based cost-effectiveness analysis of using HMEs versus usual care (UC) (including stoma covers, suction system and/or external humidifier) for patients after laryngectomy was performed. Primary outcomes were costs, QALYs and incremental cost-effectiveness ratio (ICER). Secondary outcomes were pulmonary infections, and sleeping problems. The analysis was performed from a health care perspective of Poland, using a time horizon of 10years and cycle length of 1year. Transition probabilities were derived from various sources, amongst others a Polish randomized clinical trial. Quality of life data was derived from an Italian study on similar patients. Data on frequencies and mortality-related tracheobronchitis and/or pneumonia were derived from a Europe-wide survey amongst head and neck cancer experts. Substantial differences in quality-adjusted survival between the use of HMEs (3.63 QALYs) versus UC (2.95 QALYs) were observed. Total health care costs/patient were 39,553 PLN (9465 Euro) for the HME strategy and 4889 PLN (1168 Euro) for the UC strategy. HME use resulted in fewer pulmonary infections, and less sleeping problems. We could conclude that given the Polish threshold of 99,000 PLN/QALY, using HMEs is cost-effective compared to UC, resulting in 51,326 PLN/QALY (12,264 Euro/QALY) gained for patients after total laryngectomy. For the hospital period alone (2weeks), HMEs were cost-saving: less costly and more effective. Springer-Verlag Berlin Heidelberg, 2015 Heat and moisture exchanger (HME) nationallicence Laryngectomy nationallicence Cost-effectiveness analysis nationallicence Pulmonary rehabilitation nationallicence Retèl Valesca Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut van den Boer Cindy Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut Steuten Lotte Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, P.O. Box 19024, 98109-1024, Seattle, WA, USA aut Okła Sławomir Department of Otolaryngology and Head and Neck Surgery, Regional Cancer Center, ul. Artwin´skiego 3, 25-734, Kielce, Poland aut Hilgers Frans Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut van den Brekel Michiel Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2381-2388 0937-4477 272:9<2381 2015 272 405 https://doi.org/10.1007/s00405-015-3618-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-015-3618-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Retèl Valesca Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- van den Boer Cindy Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Steuten Lotte Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, P.O. Box 19024, 98109-1024, Seattle, WA, USA aut NATIONALLICENCE 700 1- Okła Sławomir Department of Otolaryngology and Head and Neck Surgery, Regional Cancer Center, ul. Artwin´skiego 3, 25-734, Kielce, Poland aut NATIONALLICENCE 700 1- Hilgers Frans Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- van den Brekel Michiel Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2381-2388 0937-4477 272:9<2381 2015 272 405