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Cost analysis of managing B3 breast lesions by vacuum excision at Leeds Breast Unit using a decision model

Lookup NU author(s): Dr Gurdeep SagooORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Objective: To develop an economic model to evaluate the cost of using vacuum-assisted excision (VAE) for managing B3 breast lesions. Design: A decision tree of managing B3 breast lesions was developed to compare the costs of VAE with diagnostic excision (DE) from the perspective of the healthcare provider. Two different diagnostic pathways were compared which describe alternative approaches to the management of B3 lesions using inputs derived from a mix of primary and secondary data. Setting: Based on a study conducted at Leeds Breast Unit, UK. Participants 398 patients enter the model having undergone initial core needle biopsy, or vacuum-assisted biopsy, and diagnosed with B3 breast lesion. Main outcome measures The economic impact, in terms of cost, of various scenarios using analysis of extremes and probabilistic sensitivity analysis. Results VAE reduced the cost per patient by £1510.75. Analysis of extremes showed that managing B3 lesions using VAE was cost saving except the case where a combination of the highest cost associated with VAE and the lowest cost for DE were used. Probabilistic sensitivity analysis showed that using VAE for managing B3 lesions has a probability of 0.9 of being cost saving compared with using DE. Conclusion This analysis shows the potential cost saving of using VAE as an alternative for managing B3 breast lesions compared with DE. Further research in this area and the effect of the VAE on patients' quality of life is warranted.


Publication metadata

Author(s): Yaziji N, Sharma N, Selfridge J, Sagoo GS

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2021

Volume: 11

Issue: 12

Online publication date: 30/12/2021

Acceptance date: 07/12/2021

Date deposited: 18/06/2024

ISSN (print): 2044-6055

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/bmjopen-2021-054525

DOI: 10.1136/bmjopen-2021-054525

Data Access Statement: No data are available. The data used in the analysis were extracted from a published study by Strachan et al: 'Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current UK practice?'.


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Funding

Funder referenceFunder name
National Institute for Health Research Leeds In Vitro Diagnostics Co-operative

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