Presentation (CTI)

OBJECTIVES: Coblation Intracapsular Tonsillectomy (CIT) has emerged as a potential alternative to standard total tonsillectomy (TT) using cold steel for managing sleep-disordered breathing and recurrent tonsillitis. This study evaluates the cost-effectiveness and health outcomes of CIT compared with TT in a Brazilian healthcare context, using data derived from a recent meta-analysis and other literature sources.
METHODS: A cost-effectiveness model was developed to compare CIT and TT in patients with sleep-disordered breathing or chronic/recurrent tonsillitis. In the absence of Brazil-specific clinical data, international event rates and relative risks were assumed applicable to the Brazilian population. The analysis focused on CIT’s impact on postoperative bleeding and associated healthcare resource use. Outcomes included bleeding episodes avoided, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICERs). Subgroup and sensitivity analyses were performed, particularly for adult patients.
RESULTS: For a cohort of 1,000 patients, CIT led to a cost increase of R$350,918 (R$351 per patient) compared with TT, while preventing 36.95 bleeding episodes and gaining 9.95 QALYs. The ICERs were R$9,498 per bleeding episode avoided and R$35,253 per QALY. Subgroup analysis in adults showed slightly higher ICERs (R$10,609/bleeding episode and R$39,377/QALY), driven primarily by differences in resource use. Sensitivity analyses confirmed that the model’s outcomes were most influenced by the cost of CIT and its effectiveness in reducing bleeding.
CONCLUSIONS: CIT is estimated to be cost-effective in both pediatric and adult populations in Brazil, primarily due to its reduction in postoperative bleeding. Although cost assumptions and clinical effectiveness drive the model results, findings remain stable under sensitivity analysis, supporting CIT as a viable alternative to TT in relevant clinical scenarios.