Cost-utility of breast reduction surgery - A prospective study

SummaryObjectiveTo assess the cost-utility of routine breast-reduction surgery in the setting of a large university hospital.MethodsIn the framework of a large trial exploring the feasibility of routine health-related quality of life (HRQoL) assessment, 80 patients (mean age: 45 years) entering the Department of Plastic Surgery for operative breast reduction filled in the 15-dimension (15D) HRQoL survey before and 6 months after surgery. Data on hospital costs were obtained from the hospital records.ResultsMean (±SD) HRQoL score (on a 0–1 scale) increased as a result of surgery from the preoperative 0.916 ± 0.075 to 0.939 ± 0.076 (p < 0.001) 6 months after surgery, corresponding to a mean (±SD) gain of 0.930 ± 2.117 quality-adjusted life years (QALYs). Of the 15 health dimensions, discomfort and symptoms showed the greatest improvement (p < 0.001). A statistically significant improvement was also seen on the dimensions of breathing, sleeping and distress.Mean hospital cost of treatment was €3383 ± 1744, and the cost per QALY was €3638. Using 5% discounting for QALYs, the cost per QALY increased to €8973.ConclusionBreast-reduction surgery improved HRQoL in a statistically significant manner and at a reasonable cost, as the cost per QALY was in the same range as that observed in our material, for example, for hip-replacement surgery.