Cost-effectiveness of coblation compared with cold steel tonsillectomies in the UK
Authors: JF Guest, K Rana, C Hopkins.
Source: Journal of Laryngology & Otology 2019;132:1119–1127.
Objective. This study aimed to estimate the cost-effectiveness of Coblation compared with
cold steel tonsillectomy in adult and paediatric patients in the UK.
Method. Decision analysis was undertaken by combining published clinical outcomes with
resource utilisation estimates derived from a panel of clinicians.
Results. Using a cold steel procedure instead of Coblation is expected to generate an incremental
cost of more than £2000 for each additional avoided haemorrhage, and the probability
of cold steel being cost-effective was approximately 0.50. Therefore, the cost-effectiveness of
the two techniques was comparable. When the published clinical outcomes were replaced
with clinicians’ estimates of current practice, Coblation was found to improve outcome for
less cost, and the probability of Coblation being cost-effective was at least 0.70.
Conclusion. A best-case scenario suggests Coblation affords the National Health Service a
cost-effective intervention for tonsillectomy in adult and paediatric patients compared with
cold steel procedures. A worst-case scenario suggests Coblation affords the National Health
Service an equivalent cost-effective intervention for adult and paediatric patients.
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