OBJECTIVES : Abdominal Adhesions are common after gynecologic surgeries, and lead several complications such as small bowel obstruction, infertility and chronic pain, which may induce huge economic burden. GYNECARE INTERCEED® Absorbable Adhesion Barrier as adjuvant materials can reduce the incidence of adhesion during gynecologic surgeries. This study evaluated the cost-effectiveness of INTERCEED in preventing adhesion after open gynecologic surgeries from a payer’s perspective in China.

METHODS : A Markov-decision tree model was constructed to evaluate cost-effectiveness of adopting INTERCEED for women undergoing open gynecologic surgeries. The decision-tree included adhesions and adhesion related complications within the first year after the surgery; The Markov chain included three health states of complications with additional treatment, complications without additional treatment and no complications. C-section surgery, hysterectomy, myomectomy, ovarian surgery, tubal surgery, and endometriosis surgery were modeled with and without use of INTERCEED. Clinical data were obtained from published literature and clinical experts survey. Cost and utility data were obtained from the literature. The model calculated quality-adjusted life years (QALYs) and total cost per patient in a 3-year horizon. A one-way sensitivity analysis was conducted for all parameters.

RESULTS : Compared to no INTERCEED group, patients with INTERCEED group (following C-section surgery, hysterectomy, myomectomy, ovarian surgery, tubal surgery, and endometriosis surgery) showed less overall complications and need additional treatment, resulted a cost saving of ¥1,576, ¥600, ¥256, ¥428, ¥772, ¥1,288 per patient respectively. INTERCEED group also gained additional QALY 0.011, 0.008, 0.007, 0.007, 0.009, 0.010 per patient respectively. The dominant ICERs across all surgeries indicating that INTERCEED group has better efficacy and lower overall costs compared with no INTERCEED group. The one-way sensitivity analysis did not change the conclusion, indicating the robustness of the model.

CONCLUSIONS : The study suggests that using INTERCEED is a dominant clinical strategy in preventing adhesion for the patients after open gynecologic surgeries in China.