COST-UTILITY ANALYSIS OF ESP BLOCK IN SCOLIOSIS SURGERY: A FAVORABLE STRATEGY FROM AN EGYPTIAN HEALTHCARE PERSPECTIVE
Author(s)
Basma M. Elsayed, II, BSc, MSc, PhD1, Engy Sami Sami Attia, phD in anesthesia2, Mohamed Abdelfattah, MSc3, Mohamed Abdelkhaleq, .3.
1PhD candidate, Ain shams university, Cairo, Egypt, 2anesthesia , lecture of Anesthesia ,ICU, pain management, National Bank Hospital , Ain Shams University, Cairo, Egypt, 3National Bank Hospital, Cairo, Egypt.
1PhD candidate, Ain shams university, Cairo, Egypt, 2anesthesia , lecture of Anesthesia ,ICU, pain management, National Bank Hospital , Ain Shams University, Cairo, Egypt, 3National Bank Hospital, Cairo, Egypt.
OBJECTIVES: To evaluate the cost-utility of ESP block combined with total intravenous anesthesia (TIVA) compared with TIVA alone in posterior scoliosis surgery.
Posterior scoliosis correction surgery is associated with substantial postoperative pain and high opioid consumption. Ultrasound-guided erector spinae plane block (ESP block) has demonstrated clinical benefits in postoperative analgesia; however, its economic value remains uncertain.
METHODS: A secondary cost-utility analysis was conducted alongside a randomized controlled trial including 44 patients undergoing posterior scoliosis correction. Patients received either bilateral ESP block plus TIVA (n=22) or TIVA alone (n=22). Health-related quality of life was estimated using proxy-derived EQ-5D-5L utilities valued with the Egyptian tariff. Direct perioperative medical costs were calculated from the healthcare payer perspective using 2025 hospital price lists. The time horizon was limited to the first 8 postoperative hours.
RESULTS: The mean cost per patient was 7,522.12 EGP in the control group and 7,625.38 EGP in the ESP block group, resulting in an incremental cost of 103.71 EGP in the ESP block group. ESP block improved utility values (0.8337 vs 0.6655), corresponding to an 8-hours incremental QALY gain of 0.000154 (1.3456 QALH). The incremental cost-effectiveness ratio (ICER) as 77.07 EGP per QALH gained.
CONCLUSIONS: ESP block improves early postoperative quality of life in scoliosis surgery, representing at a modest incremental cost, representing a favorable strategy from a healthcare payer perspective. These findings support the adoption of ESP block as a high-value analgesic strategy in resource-constrained healthcare settings.
The authors acknowledge the use of the EQ-5D-5L instrument (EuroQol Research Foundation, Registration ID: 80452) and thank Dr. Mohamed Abdel Fattah, Dr. Abdelkhaleq, and Mr. Youssef, along with the clinical teams at National Bank Hospital, for their contributions to patient care and data collection.
Posterior scoliosis correction surgery is associated with substantial postoperative pain and high opioid consumption. Ultrasound-guided erector spinae plane block (ESP block) has demonstrated clinical benefits in postoperative analgesia; however, its economic value remains uncertain.
METHODS: A secondary cost-utility analysis was conducted alongside a randomized controlled trial including 44 patients undergoing posterior scoliosis correction. Patients received either bilateral ESP block plus TIVA (n=22) or TIVA alone (n=22). Health-related quality of life was estimated using proxy-derived EQ-5D-5L utilities valued with the Egyptian tariff. Direct perioperative medical costs were calculated from the healthcare payer perspective using 2025 hospital price lists. The time horizon was limited to the first 8 postoperative hours.
RESULTS: The mean cost per patient was 7,522.12 EGP in the control group and 7,625.38 EGP in the ESP block group, resulting in an incremental cost of 103.71 EGP in the ESP block group. ESP block improved utility values (0.8337 vs 0.6655), corresponding to an 8-hours incremental QALY gain of 0.000154 (1.3456 QALH). The incremental cost-effectiveness ratio (ICER) as 77.07 EGP per QALH gained.
CONCLUSIONS: ESP block improves early postoperative quality of life in scoliosis surgery, representing at a modest incremental cost, representing a favorable strategy from a healthcare payer perspective. These findings support the adoption of ESP block as a high-value analgesic strategy in resource-constrained healthcare settings.
The authors acknowledge the use of the EQ-5D-5L instrument (EuroQol Research Foundation, Registration ID: 80452) and thank Dr. Mohamed Abdel Fattah, Dr. Abdelkhaleq, and Mr. Youssef, along with the clinical teams at National Bank Hospital, for their contributions to patient care and data collection.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD50
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Surgery, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)