Cost-Utility Analysis of Two Therapeutic Approaches in the Management of Ostomy Patients in France

INTROCDUCTION: Around 80,000 to 100,000 people in France have a stoma, and 16,000 new ostomies are created every year. The management of ostomy patients represents a major issue, in terms of quality of life for patients and costs for the health system. Peristomal skin complications (PSCs) are the most common adverse event for stoma patients, significantly increasing management costs and impacting negatively Health-Related Quality of Life (HRQoL).

OBJECTIVES: This study aims to analyze the cost-effectiveness of two therapeutic approaches, including a comparison between the last generation of stoma appliance (LGSA) and the anterior generation of stoma appliance (AGSA), to optimize public health resources in France.

METHODS: A Markov cohort economic model is used in a cost-utility analysis to determine the benefits in quality-adjusted life years (QALYs) associated with the use of the LGSA compared to the AGSA.

RESULTS: The economic study shows that using the LGSA instead of the AGSA leads to significant savings and improved HRQoL for ostomy patients. While support accessory costs are slightly higher with the LGSA, these are offset by savings in leakage events, ostomy appliances, and overall treatment, totaling €350, €31, and €227 per patient, respectively, plus €74 in societal cost reductions. The LGSA is more cost-effective than the anterior one, with €680 lower costs per patient and a gain of 0.044 QALYs vs the comparator arm for an incremental cost-effectiveness ratio of €15,438/QALY gained, well below a willingness-to-pay threshold of €30,000/QALY. Sensitivity analysis confirms the LGSA’s economic and clinical superiority.

CONCLUSIONS: The economic analysis demonstrates that using LGSA is more cost-effective and efficient than AGSA, reducing costs and improving the quality of life for ostomy patients in France.