Cost-Effectiveness and Cost-Utility Analysis of Transvaginal vs Laparoscopic Approaches for the Drainage of Tubo-Ovarian Abscesses

OBJECTIVES: The aim of this trial-based economic evaluation was to evaluate incremental cost and cost-effectiveness of surgical approach transvaginal compared with surgical approach laparoscopic for the drainage of tubo-ovarian abscesses (TOAs).

METHODS: Economic evaluation from a healthcare system perspective alongside a non-inferiority, multicentric trial conducted in 19 hospitals in France with six weeks of follow-up. The primary endpoint was the additional cost of a patient without failure. The data was collected from case report forms (CRFs) and a microcosting analysis.

RESULTS: Of the 208 included patients, 130 (62.5%) were analyzed in the per-protocol analysis (69 in the intervention group and 61 in the control group). Preliminary results suggest differences in both clinical and economic outcomes between the transvaginal and laparoscopic approaches. The transvaginal puncture might offer a cost advantage in terms of initial costs. The Incremental Cost-Effectiveness (ICER) will be calculated to assess the additional cost of a patient without failure. Further analysis will include the cost-effectiveness plane and the acceptability curve.

CONCLUSIONS: Effective allocation of resources in healthcare is crucial for improving patient outcomes and optimizing costs. This study underscores the importance of ongoing evaluation and adaptation of surgical practices to ensure that resources are used efficiently to deliver the best possible care.