title: The cost utility of reduction mammaplasty at medium-term follow-up: a prospective study.
abstract: OBJECTIVE
  The effects of reduction mammaplasty (RM) have been proved in several randomised trials. However, publications regarding cost utility are infrequent and lacking with regard to medium-term follow-up. Therefore, we decided to assess the cost utility of RM at 2-5 years' follow-up, when later costs and possible re-operations have been incurred.
  
  
  METHODS
  A total of 73 patients had bilateral RM between January 2005 and March 2007 in the Hospital District of Helsinki and Uusimaa, Finland. Health-related quality of life was measured with the 15D. Preoperative data were collected with an interview at an appointment and follow-up data by means of a postal survey. Direct hospital costs were obtained from the Ecomed(®) clinical patient administration database (Datawell Ltd., Espoo, Finland).
  
  
  RESULTS
  A total of 62 (85%) patients agreed to participate in the study and returned the follow-up questionnaire. The mean follow-up time was 4.0 years (SD 0.53, range 2.3-4.6 years). The mean improvement in the 15D score change was 0.083 (SD 0.081). The mean number of quality-adjusted life years (QALYs) gained was 3.052 (SD 3.167, range 2.561-17.553). The mean hospital costs of the intervention were €3601 (SD 1321), and the mean cost per QALY gained was €1180. Roughly 76% of the costs were due to the hospital stay during the operation. Eight percent of the costs were incurred more than 6 months after the hospital stay.
  
  
  CONCLUSIONS
  The cost per QALY gained by RM is low, even when considering later costs caused by possible re-operations, and compares favourably with a number of other surgical procedures.
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland. kai.saariniemi@gmail.com
authors.forename: Kai M M
authors.initials: KM
authors.lastname: Saariniemi
authors.forename: Hannu O M
authors.initials: HO
authors.lastname: Kuokkanen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Räsänen
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Erkki J
authors.initials: EJ
authors.lastname: Tukiainen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D016462:Mammaplasty / Q000191:economics* / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric; D016896:Treatment Outcome