Initial modelling and updates on cost effectiveness from the first 10 years of a spleen registry

Abstract

Objective:To validate our estimates from our original model and re‐evaluate the cost‐effectiveness of Spleen Australia, the Australian post‐splenectomy registry, using our original model with updated model parameters based on advances in the literature and experience of the registry over the past decade. Methods:We revisited a decision model from 2005, comparing 1,000 hypothetical registered patients with asplenia or hyposplenism against 1,000 who were not registered, and updated the model parameters. The cost‐effectiveness of the registry was evaluated from a healthcare perspective in terms of additional cost per case of overwhelming post‐splenectomy infection (OPSI) avoided and as additional cost per life year gained. Results:Over a cohort lifetime the registry was associated with an additional cost of $125,724 per case of OPSI avoided or $19,286 per life year gained. Conclusions:Despite our initial over‐estimation of immunisation and chemoprophylaxis uptake and increases in unit costs, our re‐evaluation confirmed use of the registry to be cost‐effective. Implications for public health:Improved outcomes for patients with asplenia or hyposplenism can be achieved by a cost‐effective registry. Additional research into effectiveness of interventions, OPSI prevalence associated with varying intervention use, and compliance rates over time after registration would provide improved accuracy of cost‐effectiveness estimates.