OBJECTIVES:

Surgery as a treatment itself often could affect long-term treatments which complicated the analysis of the budget impact. This study aimed to develop and evaluate a budget impact model/BIM framework for surgical approaches according to the recommendations from ISPOR 2012 Budget Impact Analysis Good Practice II Task Force (GPII).

METHODS:

We developed a hybrid model for patients who underwent open, laparoscopic and robotic-assisted surgeries. Radical prostatectomy was used as a testing procedure. The model was designed from United Kingdom single payer system perspective, and with 1/5/7/10-year time horizon, respectively. Input data were from literature and National Health Service reference cost 2016-2017.

We evaluated this framework using the GPII, which contains recommendations for 1) 9 aspects for the analytic framework design, 2) 5 elements for inputs and data sources and 3) reporting format. The compliant and uncompliant aspects were reported. Model outputs and reports will be generated from the framework. The framework will be applied to other surgical procedures.

RESULTS:

The hybrid model included a decision-tree part for perioperative care, and a Markov part for post-surgical monitoring and follow-up treatment. For patients with localized prostate cancer who underwent radical prostatectomies, surgical equipment, conversion-to-open, perioperative complications, length of stay, and operation room were considered in the cost of perioperative care. Adjuvant therapy, recurrence monitoring, salvage therapy and treatments for adverse events were included in the post-surgical cost.

The evaluation suggests that the design of the BIM was complaint on 9 out of 9 aspects for analytic framework design; the model inputs and data sources for all 5 elements were also clearly stated. The report of BIA is under development.

CONCLUSIONS:

The BIM were complaint with GPII recommendations for analytic framework design and inputs. A guideline complaint framework is likely to provide solid foundations for further analyses and reporting of budget impacts for surgical care.