gms | German Medical Science

Introduction: Demand for septorhinoplasty is rising in Germany. Despite this, associated health benefits remain controversial. In this study, a health utility assessment and cost-utility analysis was performed for septorhinoplasty.

Method: 103 patients undergoing Septorhinoplasty at a German tertiary-level hospital completed Short Form-36 (SF-36) and satisfaction questionnaires before and 12 months after their procedure. The SF-6D instrument was used to acquire Quality Adjusted Life Years (QALYs) from SF-36 responses thus allowing estimation of pre and postoperative health utilities. Health utility gains after septorhinoplasty were combined with cost data to estimate procedural cost per QALY gained (cost-utility) from statutory health insurer’s (SHI) perspective.

Results: Patients undergoing septorhinoplasty reported mean preoperative QALY values of 0.70 preoperatively and 0.74 postoperatively, indicating health gains of 0.04 QALYs (95% CI: 0.01 - 0.07). Patients satisfied with their procedures had significant health utility gains while dissatisfied patients did not experience any significant gains. The cost of septorhinoplasty to SHI in this study was €3487.69. When compared to the baseline, the incremental utility ratio (ICUR) for septorhinoplasty was €94797.30 per QALY gained. Sensitivity analysis, based on variations in outcomes and reimbursement rates, yielded a best case ICUR of €50030.91 and worst case ICUR of €516762.86.

Conclusions: This study successfully estimated health utilities, health gains and cost-utility for septorhinoplasty, and is the first study to do so. The findings indicate that septorhinoplasty has associated health gains but at a high cost-utility ratio.

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