OBJECTIVES : To develop a country-level budget impact model/BIM for surgical approach under a single payer perspective and evaluate the BIM frame work according to the guidance from ISPOR Budget Impact Analysis/BIA Good Practice II Task Force and evaluate

METHODS : A hybrid modeling approach using a decision tree for perioperative care and a Markov model for long term treatment was applied for this BIM for patients with endometrial cancer who underwent open, traditional laparoscopic and robotic-assisted hysterectomy. The time horizon was set to 1/5/7/10 year and the study perspective was UK National Health Service/NHS. Country-level targeted population was obtained from literature using NHS Hospital Episode Statistics (HES). Model input parameters was from literature review. Cost were based on NHS National Health Service reference cost 2017-2018. Surgical equipment costs and surgical approach market share are based on publicly available information. Deterministic sensitivity analyses were performed to explore parametric uncertainties.

Further, the aspects, elements and report format of the BIM framework was evaluated against ISPOR BIA principle of good practice. The compliant and uncompliant aspects were reported. Model outputs and reports will be then generated from the framework.

RESULTS : For patients underwent hysterectomy for endometrial cancer, surgical equipment, conversion-to-open, perioperative complications, length of stay, and operation room were considered in the cost of perioperative care. Recurrence monitoring, radiation and chemo therapy, and the treatments for adverse events were included in the long-term cost.

The BIM framework for hysterectomy is complaint with ISPOR BIA Good Practice II on 9 out of 9 aspects; the data sources for all 5 elements were clearly stated. The report of BIA is under development.

CONCLUSIONS : Our study demonstrated that it is feasible to develop an ISPOR Good Practice Task Force complaint BIM for surgical approaches. A guideline complaint framework provided solid foundations for further analyses and reporting.