Cost-Effectiveness in Health: Weighing Outcomes, Costs & Alternatives for Optimal Success - Essay Sample

Introduction

Cost-effectiveness theory is used in health fields to weigh various outcomes and the relative costs of different practices and ideologies to achieve the best idea for success. Cost-effectiveness gives the public and the private finance sectors the relevant information on costs and alternatives in buying good health. The theory assumes that the value of resources must also be considered and not only the benefits or outcomes. Effectiveness is always analyzed by the standard evaluation techniques to achieve a specific goal for different alternatives. For example, various options which have the same goals are always weighed in relation to their costs and effectiveness. In this case, the choice with the least cost-effectiveness ratios are well advised with reference to the society's resources, and these alternatives ensure a few resources will be used to achieve the objectives of a certain practice.

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Cost-effectiveness plays a significant role in Health Technology Assessment as it is used to influence decision making in this health sector. HTA has to make informed decisions on the allocation of resources in the health care system. To make those decisions, HTA uses cost-effectiveness analysis with incremental cost-effectiveness ratios (ICERs). ICER involves balancing costs and the health benefits that a particular ideology must reach to be considered useful in a given health care system. ICER has two parts, that is, the informal and the formal thresholds. The use of these thresholds promotes consistency and transparency and helps in getting satisfactory ratios of monetary costs and measure of health gain. ICER thresholds, however, hinder the incorporation of societal preferences, values of different innovations, and the impact of budget on evaluation. To get cost-effectiveness, the HTA divides the total cost needed with the outcome.

Cost-Effectiveness of Greenlight XP Technology

The economic crisis in the recent past meant that health care systems had to minimize costs on their services. This can be done by maximizing short surgeries with improved recovery procedures. Technologies such as greenlight XPS enables the shift of inpatient procedures to outpatient procedures and therefore promoting savings from costs that would have been incurred from overnight stays. It also relieves pressure on the few numbers of beds available, and patients are unlikely to experience treatment delays. According to GOLIATH analysis and results, using greenlight technology in surgeries reduces hospital stay, as compared to using TURP technology.

The cost considerations for both greenlight XPS laser therapy and Transurethral resection of the prostate include the capital costs, procedure costs, and post-procedure costs. Cost-effectiveness should not be with the device that operates but with the clinical benefits. These clinical benefits include shorter recovery time and hospital stays, and fewer complications from the procedure. Greenlight XPS laser is cost-effective than TURP in terms of lower financial burdens on efficacy and outcomes. Greenlight XPS also has a lower indirect cost and a lower 25% procedural cost as compared to TURP. Greenlight XP laser therapy system has 532nm wavelength and 180W that is used to treat BPH (Benign Prostatic Hyperplasia). The greenlight XP improves the area and the power of the laser to 50% and thus giving a larger tissue vaporization effect without having to use the depth of vaporization. The 532nm wavelength promotes homeostasis by vaporizing prostate tissues, minimizing penetration and forming a thin ream of coagulated tissues which helps in the process. This process has been considered very cost-effective than using TURP to achieve the same outcomes. Greenlight XPS is therefore regarded as an appropriate treatment option which caters for patient needs as compared to TURP.

Research Methods

Interview

As a prerequisite to this project, I conducted an interview with a Sweden surgeon named Dr. Burrows, who is a specialist and a chief surgeon in his hospital. Dr. Burrows has been using the greenlight XPS laser therapy technology for over five years now. The interview helped in coming up with different conclusions about the technology.

I started the interview by asking the different effects of using greenlight technology and the problems he has experienced from using the technology on his patients. I kept stopping throughout the interview to consult on the concepts that I did not understand. The exciting part of the interview was that Dr. Burrows was very positive, and he answered all questions asked accordingly without complaining. The use of appropriate vocabularies and Dr. Burrows's cheerfulness made the interview very live.

Findings and Discussion

From the interview with the Sweden surgeon, he argued that the technology is best used on men with prostates that are smaller than 100ml, who don't have any urinary retention and have a little risk of bleeding. Dr. Burrows claimed that with proper treatment, the patient has a faster return to normal activities. The main advantage of the technology is that it reduces the hospital stay as the procedure can be done in a day. The process also reduces pain and therefore promoting a good life. The technology costs approximately 84 dollars, and therefore it is cheaper compared to the traditional surgical TURP. "Scientists should consider lack of enough evidence to support the use of greenlight in treating high-risk prostates, and the specialists research more and collect data to improve their pieces of evidence," he said.

However, Dr. Burrows argued that greenlight XPS should not be considered a panacea and that misuse of laser energy might result in serious complications. Also, the method may not be perfect if the technique is used poorly because it increases the risk of morbidity and leading to poor outcomes. He described that one should have enough comparative efficacy data and high-quality skills before performing the procedure. He said that most surgeons had been trained on performing TURP than using greenlight XP laser. "I prefer using greenlight technology to TURP since I have observed significant results from doing surgeries using greenlight technology. Transurethral resection of the prostate (TURP) is, however, not suitable for an aging population with a high risk of bleeding and blood transfusion."

According to Dr. Burrows said, treatment with greenlight XPS laser has shown some improvements in measuring standard parameters. It is the perfect option even to those patients in retention. Of the 50 patients he has treated using greenlight XPS laser therapy, only two patients had urosepsis, and five patients needed a catheterization, and there were no severe complications.

The main challenge Dr. Burrows has experienced while performing preoperative surgery is that greenlight technology doesn't provide any tissue for specimen, and therefore it is difficult to diagnose prostate cancer based on histological analysis. He adds that there are risks related to any surgical procedures and the side effects of using greenlight XP technology includes impotence, urinary tract infections, bleeding, and incontinence.

Reference

Bastard, C., Zorn, K., Peyronnet, B., Hueber, P. A., Pradere, B., Roupret, M., & Misrai, V. (2017). Assessment of learning curves for 180-W GreenLight XPS photoselective vaporisation of the prostate: A multicentre study. European Urology Focus.

Boston Scientific, (2019). GreenLight XPS: Laser therapy system. Retrieved from http://www.bostonscientific.com/en-US/products/lithotripsy/greenlight-xps/features--benefits.html

Lose, S. (2019). Danish treatment councils should be placed in the regions. Retrieved from: https://www.regioner.dk/services/nyheder/2019/maj/dansk-behandlingsraad-boer-placeres-i-regionerne