Abstracts
1997 Digestive Disease Week

Cost effectiveness analysis of octreotide in prevention of complications following pancreatic resection.

L Rosenberg. Department of Surgery McGill University, Montreal, Canada; P Mac Neil, L Turcotte. Sandoz Canada Inc., Dorval, Canada.

Recent studies have concluded that octreotide can reduce the complication rate in patients undergoing pancreatic resections. In view of the octreotide acquisition cost, a cost-effectiveness analysis was performed to establish if the additional costs associated with its use can be offset by a decrease in the consumption of other health care resources when compared to placebo. To evaluate the complication rates, a meta-analysis of double-blind, randomized, controlled clinical trials was conducted. The rates for pancreatic fistula and fluid collection were 10.7% (95% CI 7.9-13.4) and 3.6% (95% CI 1.9-5.2) for octreotide vs. 23.4% (95% CI 19.7-27.1) and 8.8% (95% CI 6.2-11.3) for placebo. Following this, we evaluated the average treatment cost for patients with and without complications using data from institutions participating in the Ontario Case Costing Project. The average cost of care for patients with or without complication was ,347 (n=17, 95% CI ,882 - ,812) and ,169 (n=18, 95% CI ,558 - ,779) respectively. The data demonstrated that, when compared to placebo, the use of octreotide was more effective and less costly. On average, octreotide use saved ,642 per patient while allowing 16 incremental patients to avoid complications. A one-way sensitivity analysis showed that no change within the 95% confidence intervals for complication rates or treatment cost would change these conclusions. A two-way sensitivity analysis of cost and complication rates showed the same robustness. We conclude that the use of octreotide is cost-effective in patients undergoing elective pancreatic resection.

This study was partly funded by Sandoz Canada Inc., Dorval, Canada.